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1 <br />i% <br />01/27/2004 16:54 FAX 14024714429 <br />NEBRASKA UCC <br />�rrw"�MR arse I <br />IA 003/004 <br />* <br />IVIN <br />- - -- <br />1008 Department of the Treasury - Internal Revenue Service <br />Form 668 (Z) <br />Certificate of Release of Federal Tax Lien <br />(Rev. 10 -2000) <br />Area: <br />Serial Number <br />For Use by Recording Office <br />SMALL BUSINESS /SELF EMPLOYED AREA #9 <br />Lien Unit Phone: (651) 312 -8080 <br />124548803 <br />wt cK of 6+.+. _,ucc too <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 July 23 <br />III 1 1111111111111111111 loll loll <br />9904314795 -7 Poo: 1 <br />2003 , is authorized to note the books to show the release of this lien for <br />KRLLOS NICKIE J <br />Filed: 01127!2004 10;21 AM <br />these taxes and additions_ <br />Name of Taxpayer <br />NICKIE J KALLOS <br />200400818 <br />Residence 516 E PLUM ST <br />GRAND ISLAND, NE 68801 -5910 <br />COURT RECORDING INFORMATION: <br />Liber Page V�,90__ t3o-:W__- •- --..,. Serial No. <br />--",0200309430 <br />n/a n/a 286 604 -7 <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 />Refilling <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(fl <br />940 <br />12/31/2002 <br />47- 0395808 <br />03/17/2003 <br />04/16/2013 <br />92.06 <br />941 <br />03/31/2002 <br />47- 0395808 <br />12/23/2002 <br />01/22/2013 <br />593.09 <br />941 <br />06/30/2002 <br />47- 0395808 <br />12/09/2002 <br />01/08/2013 <br />1051.69 <br />941 <br />09/30/2002 <br />47- 0395808 <br />04/07/2003 <br />05/07/2013 <br />1394.05 <br />941 <br />12/31/2002 <br />47- 0395808 <br />04/07/2003 <br />05/07/2013 <br />1204.46 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 4335.35 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 21st day of January 2004 <br />ST PAUL, MN <br />, on this, <br />Signs .r Title Compliance Technical. Support <br />e� Manager <br />(NOTE: Certificate of officer authorised by law to take acknowledgments is not essential to the validity of Certificate of Release of <br />c.,,, aid 7 dRR 1g71 - 9 C. R. 4091 AAa 17i IR<v 7n =7nnn1 <br />