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a�r��� 77� <br />Form 669 -� Department ofi Yhe Treasury - Intemal Revenue Service <br />(September 2008) Certificate of Discharge vf Property From Federal Tax Lien <br />(Section 6325(b)(2)(B) of the Intemal Revenue Code) <br />TODD W FRIESEN of 4134 W FAIDLEY AVE, City of GRAND ISLAIVD, County of HALL, State of NEBRASKA, is indebted to the <br />United States for unpaid internai revenue tax in the sum of Thirteen Thousand One Hundred Fourteen and Forty Nine/100 Dollars <br />(13,114.49) as evidenced by: <br />NoUce of Federal <br />Tax lien <br />Serial N�mber <br />(a) <br />698565110 <br />Recording Information <br />(b) <br />Rec.No201006864 <br />UCC#9910637981-5 <br />Title <br />Group Manager Technical Services <br />Date Recorded <br />(c) <br />09/21 J2010 <br />Taxpayer ldentification Mumber <br />(d) <br />xxx-xx-6717 <br />A lien attaching to a11 the property of the taxpayer was filed to secure the amount owed. The notice of lien was filed with the <br />Register of Deeds, for the County of Hall, and also with the Nebraska Secretary of State UCC Division, in accordance with the <br />applicable provisions of law. <br />The lien listed above is attached to certain property described as: <br />Lot 27 of Hawthorne Place, in the City of Grand Isiand, Ha11 Counfiy, iVE. <br />Locally Known As: 915 S. Sycamore St Grand Island, IVE <br />NOTE: Always include the address of real prop�rty or a descriptive narrative of personal property in this section when using <br />"See AttachmenY' and a more detailed description is being attached. <br />The United States' interest in the above described property under the referenced lien is novu valueless. Therefore, under <br />Section 6325(b)(2)(B) ofi the lnternal Revenue Code, the Internal Revenue Service discharges the above described property <br />fror�, lien. However, the lien remains in efifect for all other property, or rights to property, to which the lien is attached. <br />Amourrt Shown on Lien <br />(e) <br />$13,114.49 <br />Date <br />08/23/2011 <br />(Note: Certificate of officer authorized by law to take acknowledgements is not essential to the validity ofi Discharge of <br />Federal Tax Lien. Rev. Rul. 71-46 1971-2, C.B. 409.) <br />Catalog No, 16751 G Form 669-C (Rev. 9-2008) <br />