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20250 <br />685 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2504000114-7 Pages: 1 <br />Debtor Name: GORDON P BLAKE <br />Filing Date and Time: 04/04/2025 08:45 AM <br />Form 668(Z) <br />i:Rev. 10.2000) <br />3005 Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br />Area: <br />SMALL BUSINESS/SELF EMPLOYED AREA #6 <br />Lien Unit Phone: 1800) 913-6050 <br />Serial Number <br />433000121 <br />For Use by Recording Office <br />I certify that the following -named taxpayer, under the requirements of section 6326 (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 July 01 <br />2021 is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br />Name of Taxpayer <br />GORDON P & ROSEMARY BLAKE <br />Residence2455 LAMAR AVE <br />GRAND ISLAND, NE 68803-6233 <br />COURT RECORDING INFORMATION: <br />Liber Page UCC No Serial No. <br />n/a n/a 2107000005-1 202105633 <br />Kind of Tax <br />fa) <br />Tax <br />fb1 <br />Identifying Number <br />(ol <br />Date of <br />Assessment <br />fdl <br />Last for <br />(e1 <br />Unpaid Balance <br />of Assessment <br />101 <br />1040 <br />1040 <br />1040 <br />******* <br />12/31/2017 <br />12/31/2018 <br />12/31/2019 <br />*********** <br />XXX-XX- 0433 <br />XXX-XX-0433 <br />XXX-XX-0433 <br />************ <br />07/23/2018 <br />11/18/2019 <br />04/19/2021 <br />* ******** <br />08/22/2028 187.25 <br />12/18/2029 7410.20 <br />05/19/2031 28027.93 <br />************************** <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />Total $ <br />35625.38 <br />This notice was prepared and signed at <br />the <br />CHICAGO, IL <br />24th day of January , 2025 <br />on this, <br />Signature <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, Rut. 71-466, 1971 - 2 C.B. 4091 <br />Part t - RECORDING OFFICE <br />Form 648 (Z) (Rev. 10-20001 <br />CAT. NO 600261 <br />