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Nebraska Identification Number <br />26960397 <br />Federal Identification Number <br />Social Security Number <br />XXX -XX -6744 <br />Spouse's Social Security Number <br />Lien Serial Number <br />11280733 <br />Lien filed with Register of Deeds <br />Date of Lien 'Tax <br />05/16/2012 <br />Category <br />22 <br />County <br />HALL <br />I BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />DAVID M SANDSTED <br />2431 DEL MONTE AVE <br />GRAND ISLAND NE 68803 <br />I Type of Action l <br />02/15/2013 FRI 12:22 FAX 402 471 4429 UCC SECRETARY OF STATE <br />201301285 <br />k arrtsttrtNift at <br />�-- State Tax Lien Statement of Termination or <br />rrMbiss <br />E <br />REVE Certificate of Partial Release or <br />wwewraur :r�r.yt <br />Subordination <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 2009 <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 />Q SUBORDINATION. The State Tax Lien is subordinated as follows. <br />sign <br />here Preparer' <br />orized Signatur <br />.4 .4 <br />PLEASE DO NOT WRITE IN THIS SPACE <br />UCC Instrument Numttbr 9912692339 <br />County Instrument Number 2 01203996 <br />Continuance: UCC Instrument Number <br />Continuance: County Instrument Number <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in <br />determination of the termination, partial release, or subordination indicated above. <br />Hall III004 /004 <br />UCC Instrument Number <br />County Instrument Number <br />UCC Instrument Number <br />County Instrument Number <br />NE See of State John A Gale - UGC TO <br />9913708844 -7 Ps : <br />SANDSTED DAVID M <br />Filed: 02/15/2013 11:15 AM <br />Revenue Agent 02/14/2013 (402)471 -6043 <br />Title Date Telephone Number <br />A Li ster ee-,,f--/ rfisea /see z • /'. /3 <br />Title Date <br />4-232 -68 Rev. 8.98 Supersedes 4.232 .69 Rev. 1095 <br />