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10/26/2012 FRi 15:07 FAx 4p2 471 4429 UCC SECRETARY OF STATE -��-� Hall <br />.� <br />�4�2U9�3� <br />�ooz/ooa <br />� UCC T09 <br />2 09:38 AM <br />:?4' <br />� � ;��„� ,�"� State Tax Lien Statement of Termination or . <br />���1�� Certificate of Partial Release or <br />�...,,w�,�.. �.��.� <br />_ �� Subordination <br />n-us <br />Pursuant to the revenue laws of the State of Nebraska, notice is hereby � pL�E RETURN T0: <br />given that the State Tax Lien which has been duly filed by the Nebraska NEBRASKA DEPT OF REVENUE <br />Department of 6ievenue�agains�t^�he below-namerd tau�raye�, is � � 1313 FARNAM-ON THE-MALL <br />terminated, partially released, or subordinated to the extent indicated OMAHA NE 68102-1871 <br />below: � <br />securfty <br />98791001 <br />XXX-XX-7656 <br />Lien Serial Numbar Lien filed with T �Date of Lien Tax Category - Counry �� • <br />52241422 QX Register of oesds []County� Clerk . 03/10/2006 � 22 - ' Na11, . �' <br />BUSlNESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND�MAILING ADDk��SS ,,.:,... . <br />Business Name . . . .., _ . Name - . _ . . • • ,- t . . . <br />. . , , . . . . . <br />. James A. Lewis � � � <br />Street Address ' �'` ' Street orMailing Add�ess <br />,�, .. , . , . . ,. • ; i: <br />� --� - ' 107 S Oak St Apt 2 ' � � ' ' � �' <br />City State- Zip Code City State .,• Zip Code '� <br />... Grand Island NE 68801 <br />_. Type of Actlon • • <br />�]X TERMINA7'ION OF TAX LIEN. The State Tex Lien is hereby fully terminated. UCC Instn�ment Number 99�6442�'095 <br />County Instrument Number 20060274T . <br />TAX YEARS (corRorate� fndivtdual income. and withholding tax only) 2003, 2004 <br />Q PARTIAL RELEASE The State Te�c Lien fs partially reteased as follows: uCC Instrument Number `.' �i <br />' County {nstrument Number ' � • ' • . ' . , .', t <br />TAX YEARS (corporate, individual income, and wfthholding bx oNy) � <br />� SUBORDINATION. The State Tax Lien is subordinated as follows. UCC Instrument Number <br />• County InstrumeM Number <br />� herehvi certifi, that the �aska Deoartrnent of Revenue has comoiied with the revenue laws of the State of Nebraska in +• <br />sign <br />here <br />determination <br />or subordinaUon indiqted above. . - • •� • • • • • <br />�� Revenue Agent 10/24i2012 . 308 632-1206 <br />Title Date � :Teleptio�n�;Numtiet� <br />�- Revenue Su�ervisor ' ' 10/2412012 <br />Title Date <br />.. 4-232�68 Rev. b-88 Supedsedas 4232�59 Rav. 10-95 �. : <br />; <br />m <br />