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10/01/2020 12:43:30 PM -0500 IRS <br />202007511 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2010000049-0 Pages: 1 <br />Debtor Name: SHANNON CROSBY <br />Filing Dale and Time: 10/02/2020 09:04 AM <br />PAGE 3 OF 4 <br />Form 668 (Z) <br />May.10-20001 <br />3623 Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br />Area: <br />SMALL ROSINESS/SELF EMPLOYED AREA 66 <br />Lien Unit Phone: (800) 913-6050 <br />Serial Number <br />For Use by Recording Office <br />321610918 <br />I certify that the following -named taxpayer, under the requirements of section 8325 (a) <br />of the Internal Revenue Code has satisfied tho taxes listed below and all statutory <br />additions. Therefore, the Yen provided by Code section 8321 for these taxes and <br />additions has been released. The proper officer in the office where the notice of <br />internal revenue tax Yen was filed on Se teluber 07 <br />2018 is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br />Name of Taxpayer <br />SHANNON CROSBY <br />Residence3763 W CAPITAL AVE APT N313 <br />GRAND ISLAND, NE 68803-1307 <br />Liber <br />n/a <br />COURT RECORDING INFORMATION: <br />Page �UCC,No_ Serial No. <br />n/a C,.. 991.8819103 -"I 201805884 <br />Kind of Tax <br />(a) <br />6672 <br />6672 <br />6672 <br />6672 <br />6672 <br />6672 <br />6672 <br />6672 <br />6672 <br />6672 <br />6672 <br />6672 <br />6672 <br />6672 <br />6672 <br />******** <br />Place of Filing <br />Tax Period <br />Ending <br />(b) <br />Identifying Number <br />(c) <br />Date of <br />Assessment <br />(d) <br />last_ Da3r for <br />(e) <br />12/31/2009 <br />03/31/2010 <br />06/30/2010 <br />09/30/2010 <br />12/31/2010 <br />03/31/2011 <br />06/30/2011 <br />09/30/2011 <br />12/31/2011 <br />03/31/2012 <br />06/30/2012 <br />09/30/2012 <br />12/31/2012 <br />03/31/2013 <br />06/30/2013 <br />*********** <br />XXX -XX -4476 <br />XXX -XX -4476 <br />XXX -XX -4476 <br />XXX -XX -4476 <br />XXX -XX -4476 <br />XXX -XX -4476 <br />XXX -XX -4476 <br />XXX -XX -4476 <br />XXX -XX -4476 <br />XXX -XX -4476 <br />XXX -XX -4476 <br />XXX -XX -4476 <br />XXX -XX -4476 <br />XXX -XX -4476 <br />XXX -XX -4476 <br />************* <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />12/14/2035 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />************ <br />Balance <br />offAssesstnent <br />(1) <br />1647.74 <br />2101.19 <br />4370.98 <br />5518.48 <br />6634.48 <br />9685.94 <br />15553.60 <br />14581.52 <br />15927.93 <br />12889.59 <br />15511.72 <br />13520.14 <br />13340.43 <br />8715.08 <br />11272.44 <br />******* <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />Total $ <br />151271.26 <br />This notice was prepared and signed at <br />the_ <br />Signature <br />19th dayof September, 2020, <br />CHICAGO, IL <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.B. 4091 Form 660 (1) (Rev. 10-20001 <br />Para I - RECORDING OFFICE CAT. NO 600261 <br />Fax to 4024114429, SOS Uneonn Commercial Code, From IRS Page 3 of 4 received on 10€1!2020 12:43: Ta PM (Cental Daylight Tope) on Server STNFAXOt <br />