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NE Sec of State - Robert B. Evnen <br />Filing Document #: 2008000410-9 Pages: 1 <br />Debtor Name: TERESA RUZICKA <br />'Filing Date and Time: 08/12/2020 09:48 AM <br />202005915 <br />Form 660 (Z) <br />(Rev. 10-2000) <br />17505 Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br />Area: <br />Serial Number <br />For Use by Recording Office <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800l 913-6050 <br />995106414 <br />I certify that the following -named taxpayer, under the requirements of section 6325 tat <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 hied on Apri1 24 <br />2014 <br />, is authorized to note the books to show the release of this lien <br />for <br />these taxes and <br />additions, <br />Name of Taxpayer <br />TERESA RUZICKA <br />Residence816 E SOUTH ST <br />GRAND ISLAND, NE 68801 <br />COURT RECORDING INFORMATION: <br />Liber Page UCC No. Serial No. <br />xi/a n/a(L.9914734612-0--, 201402451 <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 />at) <br />IcI <br />NI <br />(el <br />((I <br />6672 <br />06/30/2011 <br />XXX -XX -4198 <br />03/11/2013 <br />04/10/2023 <br />710.48 <br />6672 <br />09/30/2011 <br />XXX -XX -4198 <br />03/11/2013 <br />04/10/2023 <br />7341.24 <br />6672 <br />03/31/2012 <br />XXX -XX -4198 <br />03/11/2013 <br />04/10/2023 <br />6693.26 <br />6672 <br />06/30/2012 <br />XXX -XX -4198 <br />03/11/2013 <br />04/10/2023 <br />5922.50 <br />******* <br />***************************************************************** <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 20667.48 <br />Grand Island, NE 68802-1692 <br />This notice was prepared and signed at <br />the <br />15th day of July 2020 <br />CHICAGO, IL <br />, on this. <br />Signature <br />11,L. awor- <br />Title <br />Operations Manager, <br />Centralized Lien Operation <br />(NOTE: ceruticare of oihcer authorited by law to take ,iGknov,,I Agments n, not evneetial to the validily (/1 C0r i1oti ol tt.19ass of <br />'ecivral Tax !leo Rev. II el it 466. 197t 2 C.6 409: <br />FrffP 666 (Z) iNto 10-2000) <br />Part 1 - RECORDING OFFICE CAT, NO 600261 <br />