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Nebraska Identification Number <br />36649309 <br />Federal Identification Number <br />Social Security Number <br />XXX - XX - 0481 <br />Spouse's Sodal Security Number <br />Lien Serial Number <br />10933016 <br />Lien filed with Register of Deeds <br />Date of Lien <br />11/30/2009 <br />Tax Category <br />22 . <br />County <br />HALL . <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />CORY L FULTON <br />609 W KOENIG <br />GRAND ISLAND NE 68801 <br />Type of Action <br />12/10/2012 MON 16:13 FAX 402 471 4429 UCC SECRETARY OF STATE <br />03 <br />Pursuant to the revenue laws of the State of Nebraska, notice is hereby <br />given that the State Tax .Lien which has been duly filed by the Nebraska <br />Department of Revenue against the below -named taxpayer, is <br />terminated, partially released, or subordinated to the extent indicated <br />below. <br />• ® TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated <br />TAX YEARS 2005 <br />(corporate, Individual income, and withholding tax only) <br />0 PARTIAL RELEASE. The State Tax Lien is partially released as follows: <br />TAX YEARS <br />(corporate, individual income, and withholding tax only) <br />SUBORDINATION. The State Tax Lien is subordinated as follows. <br />sign <br />here <br />201210443 <br />Hall <br />NE Sec of 5 +a a John A Gale - UCC TO <br />11 11 11 <br />9912704331 -4 Pgs: 1 <br />FULTON CORY L <br />Filed: 12/10/2012 10:53 AM <br />�N.bia ska Dp anm° REVENUE <br />State Tax Lien Statement of Termination or <br />�srt of <br />Certificate of Partial Release or <br />WVWW.M�yigifi.tl�. <br />Subordination <br />PLEASE D0 NOT WRITE IN THIS SPACE <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />1313 FARNAM-ON-THE-MALL <br />OMAHA NE 68102 -1871 <br />UCC Instrument Numb 990961318 <br />County Instrument Number 200909489 <br />Continuance: UCC Instrument Number <br />Continuance ouinty Instrument t <br />UCC Instrument Number <br />County Instrument Number <br />UCC Instrument Number <br />County Instrument Number <br />I -% t Ne braska Department of Revenue has complied with the revenue laws of the State of Nebraska in <br />dete . f 1. n , partial release, or subordination indicated above. <br />/ / Revenue 'Agent 12/06/2012 <br />. ; Itle Date <br />.�; rim/ - e—L ) �v u.2 1`S .- <br />nature I Title Date <br />(402)595 -2091 <br />Telephone Number <br />4. 232.80 Rev. 8.96 Supersedes 4-23249 Rev. 1045 <br />1002/002 <br />