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Form -*- (Z) <br />(Rev. 10-2000) <br />11874 Department of the Treasury - Internal Revenue Servi 2018000 <br />Certificate of Release of Federal Tax Lien <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913 -6050 <br />Serial Number <br />591221809 <br />For Use by Recording Office <br />NE <br />sae <br />of <br />56s <br />a <br />John <br />A <br />Sale <br />- UCC <br />[REM <br />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 />V <br />i <br />I <br />internal revenue tax lien was filed <br />on October 29 <br />9919803823 <br />- 9 Pest <br />2009 <br />, is authorized to note <br />the hooks to show the release of this lien for <br />Filed: 01 / ALBERTO <br />Filad; tl1/03l201B 01:16 PM <br />these taxes and <br />additions. <br />Name of Taxpayer <br />ALBERTO LUNA -REYNA <br />Residence 512 S LINCOLN AVE • <br />GRAND ISLAND, NE 68801 <br />COORT RECORDING INFORMATION: <br />Liber Page UCC Serial No. <br />n/a n/a 909610754 -0 200908648 <br />Tax Period <br />Date of <br />Last Dly for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />identifying Number <br />Assessment <br />Reining <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(f) <br />6721 <br />12/31/2005 <br />XX- XXX0587 <br />03/23/2009 <br />04/22/2019' <br />641.00 <br />941 <br />09/30/2006 <br />XX- XXX0587 <br />05/11/2009 <br />06/10/2019 <br />462.34 <br />*******'********************************** <br />**'* * * *'* ** * *t <br />** * ** ***. * * * ** * ** <br />• <br />• <br />Place of Filing <br />Register of Deeds • <br />Hall POBOX 1692 Total <br />$ 1103.34 <br />Grand Island, NE 68802 -1692 <br />Jean. 3. 2018 3:08PM <br />v o <br />NE Secretary of State — UCC <br />No. 3170 • r 2/3 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the <br />Signature <br />14th d o f December , 2017, <br />a <br />Title <br />Operations Manager, <br />Centralized Lien Operation <br />(NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of <br />Federal Tex lien Rev. Rul. 71 -466, 1971 - 2 C.B. 409) Form 66H (Z) (Rev. 10 -2000) <br />Part 1 - RECORDING OFFICE <br />CAT. NO 600261 <br />62. <br />