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NE Sec of State - Robert B. Evnen <br />Filing Document #: 2104001310-0 Pages: 1 <br />Debtor Name. RONALD F KING <br />Filing Date and Time: 04/21/2021 09:22 AM <br />202103237 <br />--*-- <br />Form 668 (Z) <br />(Rev. 10-2000/Certificate <br />17489 Department of the Treasury -Internal Revenue Service <br />of Release of Federal Tax Lien <br />Area: <br />SMALL BUSINESS/SELF EMPLOYED AREA 114 <br />Lien Unit Phone: (800) 913-6050 <br />Serial Number <br />842466112 <br />For Use by Recording Office <br />I certify that the <br />of the Internal <br />additions. Therefore, <br />additions has <br />internal revenue <br />2012 <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 fa) <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 January 31 <br />the books to show the release of this lien for <br />these taxes and <br />Name of Taxpayer <br />RONALD F KING <br />KINGS BAR & GRILL <br />Residence 2615 W CHARLES ST <br />GRAND ISLAND, NE 68803-5702 <br />COURT RECORDING INFORMATION: <br />Liber Page UCC No. Serial No. <br />n/a n/a 9912683678-2 201200808 <br />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(b) <br />Identifying Number <br />(C) <br />Date of <br />Assessment <br />(d) <br />Last <br />Renting <br />Day for <br />r•) <br />Unpaid Balance <br />of Assessment <br />(n <br />940 <br />940 <br />************************************************************************** <br />12/31/2008 <br />12/31/2010 <br />XX-XXX2920 <br />XX-XXX2920 <br />12/19/2011 <br />12/19/2011 <br />01/18/2022 <br />01/18/2022 <br />304.97 <br />202.14 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802-1692 <br />$ 507.11 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the <br />17th day of March <br />Signature <br />2021 <br />Title <br />Operations Manager, <br />Centralized Lien Operation <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. 409) Form 668 (Z) (Rev, 10-2000) <br />Part f - RECORDING OFFICE <br />CAT. NO soots+ <br />