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06/21/2013 FRI 14:51 FAX 402 471 4429 UCC SECRETARY OF STATE -.-.- Hall 11003/003 <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 />Nebraska Identification Number <br />41813421 <br />Lien Serial Number <br />11318052 <br />Federal Identification Number <br />Lien flied with Register of Deeds <br />BUSINESS NAME AND LOCATION ADDRESS <br />201 304978 <br />Type of Action <br />® TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. <br />TAX YEARS 2010 <br />(corporate, individual income, and withholding tax only) <br />Date of Lien <br />02/12/2013 <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. The State Tax Lien Is subordinated as follows. <br />sig <br />here <br />'zed Signature <br />State Tax Lien Statement of Termination or <br />REVENUE Certificate of Partial Release or <br />W.fiViortlin.�. <br />Subordination <br />Social Security Number <br />XXX -XX -4264 <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Tax Category County <br />22 HALL <br />TAXPAYER NAME AND MAILING ADDRESS <br />BRANDON J GROSSART <br />2004 E 7TH <br />GRAND ISLAND NE 68801 <br />UCC Instrument Num er 99137086556 <br />County Instrument Number 201301240 <br />Continuance: UCC Instrument Number <br />Continuance: County Instrument Number <br />UCC Instrument Number <br />County Instrument Number <br />UCC Instrument Number <br />County Instrument Number <br />NE Soo of Stale John R <br />ify tha Nebra : Department of Revenue has complied with the revenue laws of the State of Nebraska in <br />the nation, . "al ease, or subordination indicated above. <br />Revenue Agent 06/20/2013 (402)471 -5731 <br />Title Date Telephone Number <br />/(�zia z✓ r '&' n% 40 - . /3 <br />Title Date <br />4. 23246 Rev. 6-96 Supersedes 4-232-69 Rev. 10-95 <br />Gale - UCC <br />1 11 <br />Pgs: <br />9913717306 -8 <br />GROSSART BRANDON J <br />Filed: 06/21/2013 02:42 PM <br />Spouse's Social Security Number <br />T63 <br />1 <br />