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<br />Ii{f <br /> <br /> <br />~ial Number <br /> <br />For Optional Use b,y Recording Office <br /> <br />~ <br /> <br />FOlm:-6&8 <br /> <br />Oe.-rtment of the Treasu~ ~ 'ntemal Revenue Servlc::e <br /> <br />(RtW,Sepl._1978} <br /> <br />Certilicate of Release of Federal Tax Lien. <br /> <br />~ <br />.. <br /> <br />39810 <br /> <br />f ce#ify ~ as to~hefollowing-named tallpaYI!f. the requirements of section 6325(a) <br />of~ Internal Revenue Code have been satisfied for the taxes listed below and <br />for all statutory additions, Therefore. the I~n provided by Code section 6321 for <br />thel!& taxes. and additions has. been ~eas8d, The proper officer in the office <br />whe(e ttlenotice ofintemaf revenue tax fienwas filed on December 14 , <br />19--.J!1., is authorized to note the books to show the release of this lien for <br />these. taxes and additions. <br /> <br />NarIllJ of Taxpayer <br /> <br />.. .......... a.m. iii _~ {. ~ <br /> <br />ResklenCe <br /> <br />PO" u.A!l <br /> <br />83.....,6;lO.12 '( (") <br />--U (.lit) <br /> <br /> <br />KInd of Tu <br />(a) <br /> <br />Tu PerIod Ended Oate of Assasment <br />(bl (el <br /> <br />Identifying Number <br />(dl <br /> <br />unpaid Balance <br />of Assessment <br />(a) <br /> <br /> <br />:: <br /> <br />a-t?-81 <br />~ <br /> <br />~. 4'7~ <br />.. Ii{f~' <br /> <br />1,262.." <br />72J..I1 <br /> <br />P\ace;ofFillng <br /> <br />~.e. <br /> <br />....... "''''''.......". > ... ~ <br /> <br />Total $ 1.,..74 <br /> <br /> <br />This Certificale was prepared and signed at <br /> <br />OIIIalla, Nebraaka <br /> <br />,on this. <br /> <br />tbe~ day of <br /> <br />S!gnatwe <br /> <br />Allan Juliu <br /> <br /> <br />Title <br />Chief, Special Procedures (Acting) <br /> <br />fO the ve/klify <br /> <br />01 Hot"'. 01 n <br />........_..,. -u <br /> <br />Part 3 - To be used for recording purpo- <br /> <br />L <br /> <br />-1 <br /> <br />L <br />