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Nebraska Identification Number <br />10586679 <br />Federal Identification Number <br />80. 0439865 <br />Social Security Number <br />XXX -XX -9740 <br />Spouse's Social Security Number <br />Lien Serial Number <br />11366344 <br />Lion fled with <br />Date of U4n <br />07/19/2013 <br />Tex Category <br />01 <br />County <br />Hall <br />@ Register of Deeds 0County Clerk <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />Name <br />GARY I_EMBURG <br />Street Address <br />Street or Mating Address <br />2805 FT WORTH AVE. <br />City State Zip Code <br />City State Zip Code <br />GRAND ISLAND NE 68803 <br />Dec,17. 2014 2:49PM NE Secretary of State - UCC • <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 extant indicated <br />below. <br />© TERMINATION OF TAX LIEN. The State Tax Lion If herby fully terminated. UCC host Num . r 9913719590-0 _J <br />County Inst Number 201305999_ <br />TAX YEARS (corporate, individual income, and withholding tax only) 2010, 2011 & 2012 <br />PARTIAL RELEASE, The Slats Tax Lien is partially released as folows: UCC Instrument Number <br />County Instrument Number <br />TAX YEARS (corporate, Individual Income, and withholding tax only) <br />SUBORDINATION. <br />sign <br />here <br />pa Siignature, rt <br />Artharizsd SlgnMum , <br />201407934 <br />State Tax Lien Statement of Termination or <br />REVENUE Certificate of Partial Release or <br />Subordination <br />Type of Action <br />The State Tax Lien Is subordinated as follows. <br />Title <br />N H sec .r Maim John A a.lv - e66 TN <br />111111 1111111 <br />i <br />9914746225-3 Pee: 1 <br />LEMEIGRG GARY <br />Filed: 12/17/2014 11:14 AM <br />PLEASE DO NOT WRITE IN THIS SPACE <br />UCC Instrument Number <br />County Instrument Number <br />No. 8247 P. 3/6 <br />(hereby certify that the Nebraska Daparsnam of Revenue has complied with the revenue laws of the tai to o f ebraska in <br />dote on of Oa tsrminat -rtial release, or subordination indicated above. <br />Revenue Agent !. `A' 402 471 -6067 <br />����'� TRIe Data ' Telephone Number <br />Revenue Supervisor ___/ ! <br />Date <br />4 -232-e4 Rev. & Re Supersedes 4.2X2•8 Rev. 10 <br />