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✓`. <br />01/26/2005 17:09 FAX 14024714429 <br />NEBRASKA UCC <br />R006/006 <br />Form 668 (z) <br />21656 Department o the Treasury - Internal Revenue Service 2 0 0 5 0 0 6 <br />' <br />(Rev. ,0 -2000) <br />Certificate of Release <br />eas of Federal Tax Lien <br />Area: <br />Serial Number <br />For Use by Recording Office <br />WAGE & INVESTMENT AREA #5 <br />Lien Unit Phone; (651) 312 -8080 <br />399713856 <br />rn <br />{� Sic at Si�N -UCC <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 April 28 <br />9 75130 -6 <br />_ 19 9 7 is authorized to note the books to show the release of this lien for <br />SWR CL 1 t .05 AM <br />Filed: mtf2er2oms <br />these taxes and additions. <br />Name of Taxpayer <br />CLARENCE E FISHER <br />Residence 1404 W LOUISE <br />GRAND ISLAND, NE 68801 <br />COURT RECORDING INFORMA=0N.4_.__.._ <br />Liber Page UCC No. Serial °�- <br />n/a n/a n/a 97- 103114 "`� <br />Tax Period <br />Date of <br />Last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refilling <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(f) <br />1040 <br />12/31/1995 <br />505 -48 -5844 <br />10/21/1996 <br />11/20/2006 <br />33819.23 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 33819.23 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 19th day of January , 2005 <br />Omaha, NE <br />on this, <br />SK__' <br />Signature Title Director, Payment Compliance <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. Rut. 71 -466, 1971 - 2 C.E. 409) Form 666 (Z) (Rev.. 10 -2000) <br />Part t - RECORDING OFFICE CAT. NO 600261 <br />