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<br />02/03/2006 16:39 FAX 14024714429 <br />J <br /> <br />NEBRASKA Dee <br /> <br />IgJ 002/010 <br /> <br />Gb. <br /> <br />Form 668 (Z) <br />(Rev. 1().2000) <br /> <br /> <br />200601015 <br /> <br />3378 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Certificate of Release of federal Tax Lien <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 . <br />Lien Unit Phone: (800l 913-6050 231226005 <br /> <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 June 13 <br />2005 , is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br /> <br />Name of Taxpayer <br />JEFF A GRBENWALT <br /> <br />For Use b <br /> <br /> <br /> <br />9906436601-9 PilI:: 1 <br />GREENWRLT JEFF A <br />Fil.d: 02/03/2006 02:21 PM <br /> <br />Residence810 E 4TH <br />GRAND ISLAND, NE 68801-2706 <br /> <br />Kind of Tax <br />aJ <br />941 <br />941 <br />941 <br />******** <br /> <br />COURT RECORDING INFORMATION: <br />page ~e. Serial No. <br />n/a~9905~989826 200505363 <br /> <br />Tax Period <br />Ending <br />I:J <br />03/31/2001 <br />06/30/2001 <br />09/30/2001 <br />********** <br /> <br />Identifying Number <br />c, <br /> <br />Liber <br />n/a <br /> <br />47..:0755710 <br />47-0755710 <br />47-0755710 <br />************* <br /> <br />Date of <br />Assessment <br />d <br />12/06/2004 <br />12/06/2004 <br />12/06/2004 <br />********** <br /> <br />Last D~y for <br />Refdinr <br />eJ <br />01/05/2015 <br />01/05/2015 <br />01/05/2015 <br />************ <br /> <br />Unpaid Balance <br />of Assessment, <br />., <br />5513.10' <br />10532.73 <br />9808.09 <br />**************** <br /> <br />Place of Filing <br /> <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br /> <br />Total $ <br /> <br />258?3. 9,2, <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL, MN <br /> <br />, on this. <br /> <br />25th day of January <br /> <br />2006 <br /> <br />the <br /> <br />Signature <br /> <br />~(l,J a f/~ <br /> <br />Title Director, Cainpus Compliance <br />Operations <br /> <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.B. 409) Form 668 (X) (Rev. 10-2000) <br />Part t - RECO,RDING OFRCE CAT. NO 600261 <br /> <br />