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<br />07/05/2006 16:23 FAX 14024714429 <br /> <br />NEBRASKA DCC <br /> <br />III 002/003 <br /> <br />Vb n>__ <br /> <br />Form 668 (Z) <br />fRav. 10-2000) <br /> <br /> <br />1872 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br /> <br />165853304 <br /> <br /> <br />Office <br /> <br />Area: <br />WAGE & INVESTMENT AREA #2 <br />Lien Unit Phone: (800) 913-6050 <br /> <br />Serial Number <br /> <br />I certIfy that the following-named taxpayer, under the requirements of section 6325 ( <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 />edditions has been released. The proper officer in the office where the notice of <br />internal revenue tax lien was filed on April 09- <br />2004 ,is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br /> <br />9986460142-5 PgI: 1 <br />EVANS ROSS L <br />F11~: 87/06/2006 82:14 P" <br /> <br />Name of Taxpayer <br />ROSS L EVANS <br /> <br />20060598-8 <br /> <br />Residence PO BOX 2412 <br />GRAND ISLAND, NE 68802-2412 <br /> <br />Kind of Tax <br />(a) <br />1040 <br />1040 <br />******** <br /> <br />COURT RECORDING INFORMATION: <br />Page UCC?'..No-:-."_..,,-......... Serial No. <br />n/ ac~~.g"Q.~_2 2 7 308 -1,] 2004 - 03498 <br /> <br />Tax Period Date of . <br />Ending Identifying Number Assessment <br />(h) re) (d) <br />12/31/1999 508-98-7032 07/15/2002 <br />12/31/2000 508-98-7032 03/10/2003 <br />********** ************* *********~ <br /> <br />Last Day for <br />Retilinl <br />re} <br />08/14/2012 <br />04/09/2013 <br />************ <br /> <br />Unpaid Balance <br />of Assessment <br />(f) <br />2637.30 <br />4869.65 <br />**************** <br /> <br />Liber <br />n/a <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 />7506.95 <br /> <br />This ~otice was prepared and signed at <br /> <br />ST PAUL, MN <br /> <br />, on this, <br /> <br />the <br /> <br />28th. day of June <br /> <br />2006 <br /> <br />Signature <br /> <br /> <br />Title Director, Campus Compliance <br />Operations <br /> <br />(NOTE: Certificate of .offlcer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of <br /> <br />Federal Tax lien Rev. Ru\. 71-466, 1971 . 2 C.B. 4091 Form 668 (Z) (Rev. 10-2000) <br />........ 1 . ."CORDING OFFICE C':AT. NO 600261 <br /> <br />.~ <br />