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Ii 7.20+18 39FM NE Secretary .f State <br />- - * -- <br />Form 668 (Z) <br />(Rev. 10 -2000) <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913 - 6050 <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 December 22 <br />2009 , Is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br />Name of Taxpayer <br />KERRY H EDDY <br />Residencel205 CEDAR RIDGE ROAD APT 5B <br />GRAND ISLAND, NE 68803 -8064 <br />Liber <br />n/a <br />Signature <br />Tax Period <br />Kind of Tax Ending <br />1040 <br />1040 <br />1040 <br />* * * * * * ** <br />Place of Filing <br />11874 Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br />For Use by Recording Office <br />COURT RECORDING INFORMATION: <br />Page UGC Seria]. No. <br />n/a 9909614904-3_)200910064 <br />(6) <br />12/31/2001 <br />12/31/2002 <br />12/31/2004 <br />* *fie * * *** * ** <br />the 22nd day of August <br />Identifying Number <br />(c) <br />XXX-XX- 9155 <br />XXX -XX - 9155 <br />XXX -XX -9155 <br />* * * * * * * * * * ** <br />2016 <br />Serial Number <br />606993109 <br />Date of <br />Assessment <br />(d) <br />07/24/2006 <br />07/24/2006 <br />12/08/2008 <br />* * * ** * * *it * ** <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />Last Day for <br />Reining <br />(e) <br />N 0912 F 2 <br />201805882 <br />Occ cRCT4 <br />NV saw of Pala â– keia John N Pala <br />Rae! I <br />99101 -4 <br />EDDY KERRY <br />Filed, 91071201e 10:31 114 <br />Unpaid Balance <br />of Assessment <br />(f) <br />08/23/2016 7662.41 <br />08/23/2016 9476.99 <br />01/07/2019 4774.12 <br />* * * * ** * * * * * * * * * * * * * * * * * * * * * ** <br />Total $ 21913.52 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />Titl <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 Tax lien Rev. Rul. 71 -466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10 -2000) <br />D. I _ D Creiunna : AC'CICF ... _ .... <br />