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Nebraska Identification Number <br />98242008 <br />Federal Identification Number <br />Social Security Number t ' ° ` <br />XXX -XX -3661 <br />Spouses Social Security Number <br />Lien Serial Number <br />11163067 <br />Lien filed with Register of Deeds <br />bate of Lien ; ' <br />10/11/2011 <br />Tei C q y ` <br />County <br />HALL <br />I BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER giplE Aft D MAILING ADDRESS <br />CHARLIE D ELLIS <br />603 E DIVISION ST <br />GRAND ISLAND NE b8801 -2216 <br />Type of Action '- <br />�— <br />03/19/2013 TUE 15:01 FAX 402 471 4429 UCC SECRETARY OF STATE <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 2008 <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 />0 SUBORDINATION. <br />sign <br />here <br />nature <br />Title <br />, State Tax Lien Statement of Termination or <br />h*, I E Certificate of Partial Release or <br />Subordination <br />The State Tax Lien is subordinated as follows. <br />20/3021U -1 <br />PLEAS DO NOT WRITE IN THIS SPACE <br />PI-4g RETURN TO: <br />NOMSKA DEPT OF REVENUE <br />PO Ii$OX 94609 <br />LINCOLN NE 68509 - 4609 <br />1 <br />Coyoli I , guna Number 201 <br />Continuance: 4. b t umnnt Number <br />Continuance: Cotirl IVttoment Number <br />04. l0 !1 nt Number <br />�y <br />County kipvument Number <br />I hereby certify that the Nebraska Department <br />determination of the i`u i i , al <br />Revenue has complied with the reve <br />bordination indicated above. <br />nu_ Agent <br />03/14/2013 (308)632 -1206 <br />( Telephon um <br />i &9 Rev. 0.96 Supersedes 4-232-69 Rev. 10.95 <br />Hall lI002 /004 <br />NE Sec of State John A Gale - UCC TOE <br />9913710994 -8 <br />ELLIS CHARL E D <br />Filed: 03/19/2013 11:15 AM <br />a nent Number <br />iiirgont Number <br />umb99116740573 <br />Pgs: <br />• <br />