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11/10/2003 17:30 FAX 14024714429 NEBRASKA UCC <br />1008 De'pa, m *r1 _t b r y - tnfs 81 Revenue Service <br />Form 668 (Z) <br />(Rev. 10.2000) Certificate of Release of Federal Tax Lien <br />Area: Serial Number <br />SMALL BUSINESS /SELF EMPLOYED AREA #9 <br />Lien Unit Phone: (651) 312 -6080 . 390264368 <br />1 certify that the following -named taxpayer, under the requirements of section 6325 la) <br />of the Internal Revenue Cade has satisfied the taxes listed below and all statutory <br />additions. Therefore, the Hen 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 December 19 <br />2002 <br />, is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br />Name of Taxpayer <br />DEBORAH L TESMER <br />For <br />1a004/007 <br />200314879 <br />Office <br />Residence 704 W 3RD ST <br />GRAND ISLAND, NE 68801 -5826 <br />COURT RECORDING INFORMATION: <br />Liber Page UCC No. Serial No. <br />n/a n/a 249279- 00214329 <br />Tax Period Date of Last Day for unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Refiling of Assessment <br />941 <br />03/31/1999 <br />47- 0768965 <br />07/12/1999 <br />08/11/2009 <br />1468.52 <br />941 <br />12/31/1999 <br />47- 0768965 <br />05/01/2000 <br />05/31/2010 <br />1292,82 <br />941 <br />09/30/2000 <br />47- 0768965 <br />11/19/2001 <br />12/19/2011 <br />2374.42 <br />941 <br />12/31/2001 <br />47- 0768965 <br />07/15/2002 <br />08/14/2012 <br />2445.84 <br />941 <br />C3/31/2002 <br />47- 0768965 <br />11/11/2002 <br />12/11/2012 <br />2632.11 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total $ 10213.71 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 05ta day of November <br />Signature <br />2003 <br />Omaha, NE <br />, on this, <br />Title Compliance Technical Support <br />Manager <br />- Fw%s • a. a / j d&.f r I%— 1 <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. 71.486. 1971 - 2 C.B. 409) Form b68 (2) (Rev. 10 -2000) <br />Part t - RECORDMG OFFICE CAT. NO 800261 <br />