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J <br />NE Sec of State - Robed 8. Evnen <br />Filing Document #: 2012000142-4 Pages: 1 <br />Debtor Name: RONALD KING <br />Filing Date and Time: 12/03/2020 10:43 AM <br />2(2[9499 <br />Form 668 (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 SJSINESSiSELF EMPLOYED AREA 44 <br />Lien Unit Phone: (800) 913-6050 <br />874651012 <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 June <br />2 012...... <br />is authorized to note the books to <br />25 <br />for <br />lien for <br />show the release of this <br />these taxes and additions. <br />Name of Taxpayer <br />RONALD KING <br />Residence2615 W CHARLES ST <br />GRAND ISLAND, NE 68803-5702 <br />COURT RECORDING INFORMATION: <br />Liber Page UCCNoei._ Serial No. <br />n/a n/aL;..9-912694503-6:‘ 201205146 <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 />(bl <br />(c) <br />(di <br />(e) <br />(f) <br />1040 <br />12/31/2008 <br />XXX -XX -7944 <br />05/07/2012 <br />06/06/2022 <br />2984.18 <br />1040 <br />12/31/2011 <br />XXX -XX -7944 <br />05/28/2012 <br />06/27/2022 <br />98.31 <br />********************************** <br />*************************************** <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 3082.49 <br />Grand Island, NE 68802-1692 <br />This notice was prepared and signed at CHICAGO, IL <br />the <br />Signature <br />12th day of November , 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 lax lien Rev. Rul. 71-466, 1971 • 2 C.a. 4091 Form 668 (Z) May. 16-2000! <br />Part I - RECORDING OFFICE CAT. NO 600261 <br />