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NE Scc of State - Robert R. Evnen <br />Filing Document 4: 1910001014-5 Pages: 1 <br />Debtor Name: THEODORE J ROBB <br />Filing Date and Time: 10/17/2019 11:33 AM <br />201906472 <br />Form 668(Z) <br />tflay. l a 20001Certificate <br />0tT01 <br />18332 Department of the Treasury - Internal Revenue Service <br />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 />334794518 <br />For Use by Re Recording Office <br />I certify that the <br />of the Internal <br />additions. Therefore, <br />additions has <br />internal revenue <br />2018 <br />following -named taxpayer, <br />Revenue Code has <br />the lien provided <br />been released. The <br />tax lien was filed <br />, is authorized to note <br />additions. <br />under the requirements of section 6325 (a) <br />satisfied the taxes listed below and all statutory <br />by Code section 6321 for these taxes and <br />proper officer in the office where the notice of <br />on December 06 <br />the books to show the release of this lien for <br />these taxes and <br />Name of Taxpayer <br />THEODORE J ROBB <br />Residence 3740 S HWY 281 <br />GRAND ISLAND, NE 68803 <br />COURT RECORDING INFORMATION: <br />Liber Page UCG No. Serial No. <br />n/a n/a 1812000331-1 201807870 <br />Kind of Tax <br />(a) <br />Tax Period <br />E <br />(b/ <br />identifying Number <br />Al <br />Date of <br />Assessment <br />(di <br />Last D for <br />Refiling <br />(el <br />Unpaid Balance <br />of Assessment <br />(f1 <br />1040 <br />1040 <br />*****************************k*******************4*******t#*************** <br />12/31/2015 <br />12/31/2016 <br />XXX -XX -1425 <br />XXX -XX -1425 <br />04/02/2018 <br />11/20/2017 <br />05/02/2028 <br />12/20/2027 <br />9241.30 <br />24445.60 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802-1692 <br />$ 33686.90 <br />This notice was prepared and signed at <br />CHICAGO, IL <br />the 02nd day of October , 2019 <br />Signature <br />Title <br />Operations Manager, <br />Centralized Lien Operation <br />on this, <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.8. 4091 <br />Parc I - RECORDING OFFICE Form 668 (2) (Rev. 10-20001 <br />CAT. NO 600261 <br />