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04/06/2001 14:12 FAX 14024714429 NEBRASKA UCC 2005 /005 <br />S.. <br />111of1111I11i 1111111111111111111 All <br />11111 pgz , <br />ME990"3V'0'4 <br />DEZ 1 I W <br />(J t7ENDEZ VINCENT T 3R <br />Filed 04/0612001 1!.27 00 <br />200102972 <br />State Tax Lien Statement of Termination <br />Or — or Certificate of Partial Release or <br />nawasks . Subordination <br />department <br />of nneeue, I PLEASE DO NOT WRITE IN TEAS SPACE <br />Pursuant to the revenue laws of the State of Nebraska, notice Is hereby <br />given that the State Tax Uen which has been duly filed by the <br />Department of Revenue against the below -named taxpayer, is terminated, <br />partially released, or subordinated to the extent indicated below. <br />7040644 <br />Serial Number <br />9/02/329 <br />BUSINESS NAME AND <br />Tax CetagorY <br />01 & 21 <br />Lien Filed With <br />Register of Deeds E] County Clerk <br />_04CATION ADDRESS <br />Social security or reoeram i <br />508 -68 -1857 <br />Social <br />02 -23 -99 HALL <br />TAXPAYER NAME AND MAILING ADDRESS <br />Wolness Name <br />VINCENT T MENDEZ, JR. <br />Starer or Other Mailing Address <br />3treet Address <br />State 4887 S STUHR ROAD <br />state zip code <br />�mr z3p6 GRAND ISLAND NE 68801 <br />TYPE of AcrloN _ <br />®TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. INST 98 MENT NUMEEH 'O - <br />102310 03 <br />TAX YEARS (corporate, individual Income, and withholding taut only) <br />❑ PARTIAL RELEASE. The State Tax Lien is partially released as follows. INSTRUMENT NUMBER <br />TAX YEARS (corporate, Individual income, and withholding tax only) <br />❑ SUBORDINATION. The State Tax Lien is subordinated as follows. INSTRUMENT NUMBER <br />1� <br />— Pismo return to: <br />_ STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2ND ST STE 460 <br />_ GRAND ISLAND NE 68803 <br />Name d pang mak ng request and responalbielor11ing cerdt ate of partial release or subardinaron wilts appropdate Ming officer. <br />th determination of the <br />sign <br />here <br />I treroby eertifythatthe Nebraska Department of Revenue <br />termination. partial release, or mArdination indicated above. <br />OF REVENU . Whole and Canary Copies <br />0 <br />won Me revenue laws of the State of Nebraska in e <br />S�4 .1, 4,I G 301l ,385 - ^. 7- <br />Date Telephone Nc- <br />TAXPAYER • Pink Copy COUNTY OFFICE - Goldenrod Copy <br />4-262.66 Rev. a-96 SupWedn 4,23268 FW". 10- <br />