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09/21/2004 17:09 FAX 14024714429 NEBRASKA UCC <br />200409374 <br />Q002/002 <br />- - * -- <br />t <br />1872 Depart n f k' t_ n a Service <br />Form 668 (Z) <br />Certificate of Release of Federal Tax Lien <br />lRev. 10 -2000) <br />Area: <br />Serial Number <br />For Use by Recording Office <br />ee s.� of 6+.40 _ ucc Tell <br />SMALL BUSINESS /SELF EMPLOYED AREA #9 <br />Lien Unit Phone: (651) 312 -8080 <br />399715197 <br />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 />9904351304 -3 <br />internal revenue tax lien was filed on June 16 <br />Poe: I <br />GARCIA CARMEN <br />1997 , is authorized to note the books to show the release of this lien for <br />Fited: 09120/2004 04:39 PM <br />these taxes and additions. <br />Name of Taxpayer <br />JUAN P & CARMEN GARCIA <br />Residence 1821 W 9TH <br />GRAND ISLAND, NE 68801 -4617 <br />COURT RECORDING ,Lt�TOR1dIA�TON: °- - -•... __ <br />Liber Page UCC No. Seri o. ! <br />bA <br />n/a n/a n/a 97 -1 672 %, ! Q Y <br />Tax Period <br />_ _ Date_ <br />st a_vp for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Ref Ing <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(f) <br />1040 <br />12/31/1992 <br />509 -02 -5438 <br />04/01/1996 <br />05/01/2006 <br />8613.95 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 8613.95 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 15th day of September, 2004 <br />Omaha, NE <br />, on this, <br />Signature e Title Compliance Technical Support <br />� � � �.>r�-t• Manager <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.S. 4091 Form 668 (Z) (Rev. 10 -2000) <br />e_.; _ ocP(1Q1111mr. OFFICE rnT Kin RnngAl <br />