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02/03/2011 THU 15:01 FAX 402 471 4429 UCC SECRETARY OF STATE ��y Hall <br />orm 668 (Z) <br />�RB�. ias000� <br />Area: � Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />lien Unit Phone: (800) 913-6050 634158410 <br />! certify tfiat the following-named taxpayer, under the requirements of section 6.3?5 (a? <br />of the Internai 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 March 24 <br />2 O 10 , is autho�ized to note the books to show the �elease of this lien for <br />these taxes and additions. <br />Name of.Taxpayer <br />SYLVIA L CARRUTH <br />Residence 3 0 9 N DARR AVE <br />GR.AND ISLAND, NE 58803-4743 <br />COIIRT RECORDING INFORMATI01�: <br />Liber Page IICC No Serial No. <br />n/a �n/a 910622985-6 201001958_ � <br />Tax Period Date of <br />Kind of Tax Ending Identifjring Number Assessment <br />�-- � �-- �- <br />�002/002 <br />p Gda - UCC CRFTL <br />P95: 1 <br />I 10:33 RM <br />Last Day for �. ilnpaid Balance <br />Refiling of Assessment <br />1040 12/31/2005 XXX-XX-4776 06/05/20�J6 07/O5./2016 <br />1040 12/31/2005 XXX-XX-4776 10/08/2007 11/07/2017 991.80 <br />*x�****** *********,� ******�r****** ********** ************ **************** <br />� <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />7otal �.$ 991.80 <br />This notice was p�epared and signed at <br />the 19 th day of January �� 2 011 <br />Signature <br />3592 Department of the Treasury - Internal Revenue Service � p 110 �. 0 0 0 <br />Certificate of Retease of Federat Tax Lien <br />CHICAGO, IL <br />, on this, <br />� <br />ii�ie �i�rECtor, Carnpus Compliance <br />�perations <br />(NOTE: Certificate of offlcer authori2ed by law to take acknowledgments is nat essential to the validity of Certificate of Release of <br />Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 4091 Form 668 (Z) (Rev. 10-2000) <br />Part t- RECORDING OFFICE ' CAT. NO 600261 <br />, �. <br />