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Mar, 18, 2014 2:32PM NE Secretary of State — UCC No 3829 P. 3 <br />State Tax Lien Statement of Termination or <br />REVENUE Certificate of Partial Release or <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 />8687144 <br />Lien Serial Number <br />11289386 <br />Business Name <br />Street Address <br />City <br />❑ PARTIAL RELEASE. <br />Federal Identfication Number <br />Lien Ned with <br />State <br />Register of Deeds EICOunty Clerk <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAX YEARS (corporate, Individual Income, and withholding tax only) <br />Title <br />Social Security Number <br />XXX - XX - 9472 <br />Date of Lien Tax Category <br />07/18/2012 01 & 21 <br />Name <br />RAFAEL OROZCO <br />Street or Mailing Address <br />2105 N. NASHVILLE <br />(XI TERMINATION OF TAX LIEN. The Slate Tax Llen is hereby fully terminated. UCC Inset Nu mber <br />TAX YEARS (corporate, Individual income, and withholding tax only) 2010 & 2011 <br />IE Co+or E4.le ld,n aO.1O -UCC Tl. <br />M4732382 <br />mono mono RAFAEL <br />Filtd; 0211912014 11442 ref <br />Subordination <br />PLEASE DO NOT WRITE IN THIS SPACE <br />State <br />Zip Code City <br />GRAND ISLAND NE <br />Type of Action— <br />The Stale Tax Lien is partially released as follows: UCC Instrument Number <br />County instrument Number <br />0 SUBORDINATION. The State Talc Lien is subordinated as follows. UCC Instrument Number <br />County Instrument Number <br />201401506 <br />Spouse's Sodal Security Number <br />County <br />HALL <br />TAXPAYER NAME AND MAILING ADDRESS <br />912695974 <br />Zip Code <br />68803 <br />I hereby certify that the Nebraska Depar( ent of Revenue has complied w - the revenue laws of the State of Nebraska in <br />d I , on of the termin , partial release, or subordination Indicated above. <br />sign I _ Revenue Agent �� orzi 402 471 -6067 <br />here ar �P� Title Date <br />Revenue Supervisor <br />Telephone Number <br />Dale <br />&.sss.as Rev. 6.96 $' ie las 1- 29'b89 Rem 1496 <br />'L/ <br />