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:0200031,5 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2001000872-2 Pages: 1 <br />Debtor Name: JASON MILLER <br />Filing Date and Time: 01/15/2020 12:02 PM <br />08 <br />Form 668 (Z) <br />(Rev. 10-20001 <br />17505 Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br />Area: <br />SMALL BUSINESS/SELF EMPLOYED AREA #7 <br />Lien Unit Phone: (800) 913-6050 <br />Serial Number <br />373739619 <br />For Use by Recording Office <br />1 -earthy -that -the following na <br />of--theAfiterna4--Rev 4ist <br />xes tery <br />add <br />---- -- • - -• : . <br />aced- The proper officer in the office where the notice of <br />internal revenue tax lien was filed <br />on AUgUSt 29 <br />2019 <br />, is authorized to note <br />the books to show the release of this lien for <br />................... <br />these taxes and <br />additions. <br />Name of Taxpayer <br />JASON MILLER <br />Residence208 E 5TH ST APT 6C <br />YORK, NE 68832-0000 <br />COURT RECORDING INFORMATION: <br />Liber Page UCC No. Serial No. <br />n/a n/a 1908001554-3 201905280 <br />Tax Period <br />Date of <br />Last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refiling <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(1) <br />941 <br />06/30/2012 <br />XX-XXX9895 <br />07/10/2017 <br />08/09/2027 <br />4420720.61 <br />************************************************************************** <br />I certify <br />that under <br />the provisions <br />of IRC Section <br />6326, <br />the filing of <br />the Notice <br />of Federal <br />Tax Lien Under <br />Internal <br />Revenue Law <br />under IRC <br />Section <br />6321 was erroneous. <br />Therefore, <br />the <br />Notice of Federal <br />Tax Lien <br />Under Internal <br />Revenue <br />Law for the <br />taxes listed <br />above has <br />been released. <br />*********************************************************4**************** <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 4420720.61 <br />Grand Island, NE 68802-1692 <br />This notice was prepared and signed at <br />the <br />Signature <br />CHICAGO, IL <br />02nd day of January , 2020. <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 lion Rev. Rut. 71-466, 1971 - 2 C,E. 409) <br />Part I - RECORDING OFFICE Form 668 (Z) (Rev. /0-2000) <br />CAT. NO 600261 <br />