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Jan. 14, 2014 2:31PM NE Secretary of State — UCC <br />PLEASE RETURN ORI TO <br />*COMPLIANCE DIVISION* <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN, NE 68509 -4609 <br />Nebraska Identification Number <br />1308416 <br />Lien Serial Number <br />401304, <br />E BUSINESS NAME AND LOCATION ADDRESS <br />Business Name <br />Street Address <br />City <br />Federal Identification Number <br />State Zip Code <br />201400252 <br />h*bri +k *Gt- osnrne --tl• State Tax Lien Statement of Termination or <br />REVENUE Certificate of Partial Release or <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 />Lien flied with <br />©Re of Deeds °County Clerk <br />Social Security Number <br />xxx -xx -8334 <br />Date of Lien <br />12/24/2003 <br />City <br />Grand Island <br />TAXPAYER NAME AND MAURO ADDRESS <br />No. 2829 P. 3 <br />NG 90i of <br />Yto La doh.. R tl0L • L.., • -- <br />VAN DONALD 3 Pas: <br />R 1 <br />Filed: •!/14/2014 11:1$ AK <br />Tax Category <br />01 21 64 <br />Name <br />Donald R & Shirley L Vance <br />Street or Melling Address <br />2408 Cottonwood Road <br />State <br />NE <br />PLEASE DO NOT WRITE IN THIS SPACE <br />County <br />Type of Action <br />IN TERMINATION OF TAX LIEN. The State Tax Lien Is hereby fully terminated. UCC Inst Number 9904314314 -9 <br />County Mat Number 200400753 <br />TAX YEARS (corporate, Individual Income, and withholding tax only) 2002 - 2003 <br />❑ PARTIAL RELEASE. The State Tax Lien le partially released as foflawe UCC Instrument Number <br />County instrument Number <br />TAX YEARS (corporate, Individual income, and withholding tax only) <br />�] SUuORa)NATION. The State Tax Lien is subordinated as Allows. <br />Tide <br />Revenue Supervisor <br />TIM <br />UCC Instrument Number <br />County Instrument Number <br />01/09/2014 <br />Date <br />Spouse's Social Security Number <br />xxx -,oc -7054 <br />Hall <br />reby certify th - N .' ;T' Department • - Us as comp) with revenue laws . State o ' ^ • ras a in <br />inaeon of the termiriatlon, partial release, or subordination indicated above. <br />sign l Revenue Agent <br />here Pre <br />Zip Code <br />68801 <br />308 535 -8088 <br />Telephone Number <br />01/09/2014 . <br />Date <br />4- 242.88 Rev. 8- sulamwn 44 289 RN. 1O s <br />