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Nebraska Identification Number <br />36724475 <br />Federal IdantBtcadon Number <br />Social Security Number <br />lOU( - XX - 8485 <br />Spouse's Social Security Number <br />Lien Serial Number <br />41490141 <br />Lien fled with <br />Date of Liao <br />05/28/2004 <br />Tax Category <br />22 <br />County <br />Hall <br />E, Register of Deeds ■ County Clem <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAJiE AND MAILNG ADDRESS <br />Business Name <br />Name <br />Eric M Thompson <br />Street Address <br />Street or Mailing Address <br />3020 Westside Street <br />City State Zip Code <br />_.. _...... _........ ... _.. <br />City <br />Grand Island - ' - <br />Stale <br />Zip Code <br />68803 <br />NE <br />i er;,.. ,, St 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 />PARTIAL RELEASE. <br />SUBORDINATION. <br />Aor,30i. 2015 3:17PM NE Secretary of State - UCC <br />TERMINATION OF TAX LIEN. The State Tax Lien is hereby fuly lenninuted. UCC Instrument Number <br />County Instrument Number <br />TAX YEARS (corporate, individual income, and withholding tax only 2001 <br />TAX YEARS (corporate. individual Income, and withholding tax only) <br />befro im. I of neWMW he. eertpd wia+ the revenue (owe o, the Nele el ifI,ee in <br />or stltordination inllcated above. <br />Revenue Agent <br />The <br />Revenue supervisor <br />The <br />04)22)2015 300 632 -1206 <br />Date Telephone Number <br />041222015 <br />Date <br />4,73740 Row. 040 Sworsedu 473245 Rev. 1045 <br />- Thcreby Perlin that the . <br />deteminaton of ti�/ 1 <br />•Air wari <br />A <br />Nr <br />mien <br />here bare <br />thorewd c <br />201502759 <br />Type of Action <br />The State Tax Lien is partially released as tribes: UCC Instrument Number <br />County Instrument Number <br />The Stale Tax Lien is suboranaled as follows. <br />1W 1.. er aady .oh,. w <br />esia - BG[ 259 <br />9935753315,5 Psis, i <br />Flied. ri+ 5tat Ewe n <br />e4/30/2615 ®1;43 PM <br />No. n1 n <br />No. ` 57L L <br />PLEASE DO NOT WRITE IN THIS SPACE <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />UCC Instrument Number <br />County Instrument Number <br />99043603905 <br />200411216 <br />