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Form 668 (Z) <br />(Rev. 10 -2000) <br />Area: <br />SMALL . BUSINESS /SELF EMPLOYED AREA #5 <br />Lien Unit Phone: (800) 913 - 6050 <br />Name of Taxpayer <br />JERRY & CAROL DENTON <br />Residence 1513 STAGECOACH RD <br />GRAND ISLAND, NE 68801 <br />Liber <br />n /a <br />Kind or Tax <br />(a) <br />Piece of Filing <br />the <br />Dec. 1. 2017 3:33EM NE Secretary of State — UCC Nc.2759 P. 2/2 <br />1040 <br />1040 <br />* * * * * * ** <br />Signature <br />11874 Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br />Tax Period <br />Ending <br />(b) <br />12/31/2009 <br />12/31/2010 <br />* **** * * * * * ** <br />Identifying Number <br />(c) <br />08th day of November , 2017 <br />Serial Number <br />903667512 <br />I certify that the following - named taxpayer, under the requirements of section 6325 (a) <br />of the Internal Revenue Code has satisfied the taxes listed below and all statutory <br />additions. Therefore, the lien provided by Code section 6321 for these taxes and <br />additions has been released. The proper officer in the office where the notice of <br />internal revenue tax lien was filed on November 13 <br />2012 , is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br />COURT RECORDING INFORMATION: <br />Page UCC No. Serial No. <br />n/a 6912702880- 201209533 <br />Date of <br />Assessment <br />(d) <br />XXX -XX -3010 11/22/2010 <br />XXX -XX -3010 07/18/2011 <br />* * ** * * * * ** * * ** * * * * * * * * ** <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 - 1692 <br />Last Daar�rr for <br />Refiling <br />(e) <br />For Use by Recording Office <br />ME See of State John R Ga e <br />Title <br />Operations Manager, <br />Centralized Lien Operation <br />99178 02396 -9 <br />DENTON CAROL <br />Filed: 12/01/2017 09;16 RI') <br />201 708226 <br />YGG GRKTL <br />P9e: 1 <br />Unpaid Balance <br />of Assessment <br />(f) <br />12/22/2020. 10785.45 <br />08/17/2021 26148.93 <br />* * * * * * * * * * * * *- * * * * * * * * * * * * * * ** <br />Total $ 36934.38 <br />This notice was prepared and signed at CHICAGO, IL <br />on this, <br />(NOTE: Certificate of officer authorized by Iew to take acknowledgments is not essential to the validity of Certificate of Release of <br />Federal Tax lien Rev. Rul. 71 -466, 1971 - 2 C.B. 409) <br />Form 668 (Z) (Rev. 10 -2000) <br />Part 1 - RECORDING OFFICE CAT. NO 600261 <br />