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Nebraska Identification Number 10547464 Federal Identification Number Soaal Security Number XXX -XX -8355 Spouses Soda! Security Number Lien Serial Number 11201903 Lien M ed with gRe of Deeds 0 County Clerk Date of Lien 10112/2012 Tax Category 01 County Hall l BUSINESS NAIVE AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name Name Ecila Vargas Medina Street Address Street or Malting Address 108 W. 9th St. _ City State - - Zip Code City State Zip Code Grand Island Ne. 68801 Pursuant to the revenue laws of the State of Nebraska, notice 1s hereby given that the State Tax Lien which has been duly filed by the Nebraska Department of Revenue against the below -named taxpayer, is terminated, partially released, or subordinated to the extent Indicated below. Nov. 20, 2014 3 :28PM NE Secretary of State - UCC 7N TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. UCC Mat Number 9912701192 -5 County mat Number 201208691 TAX YEARS (corporate, Individual Income, and withholding tax only) 2011 PARTIAL RELEASE. The State Tax Lien is partially released as follows: UCC Instrument Number County Instrument Number TAX YEARS (corporate, individual income, and withholding tax only) El SUBORDINATION. The Stale Tax Lien is subordinated as folinee. UCC Instrument Number County instrument Number sign here p awes Signature utff• r: tenahire Vieff 201407354 Type of Action NE 641. No. 7803 P. 3 Stew 1111 Pee: 8914744965-3 rEHM EDIR vanc15 Filed: 11126/2914 e9i62 M 1es,ra o.oanw. - State Tax Lien Statement of Termination or REVEN Certificate of Partial Release or Subordination PLEASE CO NOT WRITE IN THIS SPACE I hereby car* that the Nebraska Department of Revenue has complied with the revenue laws of the fate o raska 1n deteperiyation of the terrninatig artist release, or subordination indicated above Title Dtlte / 4 - 232 - ee Rw. MS eupeidedd^,+23240 Rev. io 5 Revenue Agent tI/ //WY 402 471.6087 Title Date Telephone Number Revenue Supervisor