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11;'10/2003 17:29 FAX 14024714429 NEBRASKA LCC Form 668 (Z) :008 Department of the Treasury - Internal Revenue Service :Rev. 10 -2000i Certificate of Release of Federal Tax Lien Area: Serial Number SMALL 8USI*TESS /3ELF EMPLOYED AREA 49 Lien Unit Phone: (651) 312 -8080 390366696 1 certify that the following -named taxpayer, under the requirements of section 6325 Iai of the Internal P,evenue Code has satisfied the taxes listed below and all statutory additions. Therefore, the lien provided by Code section 6321 for these taxes and additions has been released. The proper officer in the office where the notice of internal revenue tax lien was filed on _ February 27 th 2003 , is authorized to note e books to show the release of this lien for these taxes and additions. Name of Taxpayer DEBORAH L TESMER Z 003/'007 200314878 c NVIIITOO PSI: 1 02:46 PM Residence704 W 3RD ST GRAND ISLAND, NE 68801 -5826 COURT RECORDING INFORMATION: Liber Page Serial No. n/a n/a -903259412-?)200302324 Tax Period Date of Last 4-ay for unpaid Balance Kind of Tax Ending Identlfying Number Assessment Reming of Assessment 941 12/31/2000 47- 0768965 12/16/2002 01/15/2013 2228.74 941 03/31/2001 47- 0768965 12/16/2002 01/15/2013 2077.99 941 06/30/2001 47- 0768965 12/16/2002 01/15/2013 2514.32 941 09/30/2001 47- 0768965 12/23/2002 01/22/2013. 2187.80 941 06/30/2002 47- 0768965 12/30/2002 01/29/2013 2959.76 Place of Filing Register of Deeds Hall POBOX 1692 Total $ 11968.61 Grand Island, NE 68602 -1692 This notice was prepared and signed at _ Omaha, NE on this, the 05th day of November 2003 Signature ` Title Compliance Technical Support �. -TWP& Manager (NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the valldity of Certificate of Release of Federal Tax lien Rev, RUI. 71 -466, 1971 - 2 C.B. 409) Form 66$ (Z) (Rev. 10 -2000) Part 1 - RECORDING OFFICE CAT. NO 600261 •