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Jan. 4. 2017 3:26PM <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />dlaFYr ®sMlliie State Tax Lien Statement of Termination or <br />[ E' 'ENUE 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 flied 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 />98427903 <br />Lien Serial Number <br />11433400 <br />Federal Identification Number <br />Lien filed with Register of Deeds <br />BUSINESS NAME AND LOCATION ADDRESS <br />Typo of Action <br />® TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. UGC Instrument Number 89147352022 <br />TAX YEARS 2011 County Instrument Number 201,102690 <br />(corporate, Individual Income, and withholding tax only) Continuance; UCC Instrument Number <br />Continuance! County Instrument Number <br />El PARTIAL RELEASE. The State Tax Lien is partially released as follows. <br />TAX YEARS <br />(corporate, individual income, and withholding tax only) <br />D SUBORDINATION. <br />sign <br />here <br />Auth <br />MAW <br />:PTA SIgnMY <br />The State. Tax Lien is subordinated a$ follows. <br />1 <br />Social Security Number <br />XXX - XX - 6251 <br />UCC Instrument Number <br />county instrument Number <br />UCC Instrument Number <br />County Instrument Number <br />24118Q <br />NE Sec of itAk. Jehn R <br />9917784819 -4 <br />BROWN PHILLIP M JR <br />Filed: 01/04/2017 10006 R19 <br />PLEASE D0 NOT WRITE IN THIS SPACE <br />Spouse's Social Security Number <br />Date of Len Tax Category County <br />05/01/2014 22 HALL <br />TAXPAYER NAME AND MAILING ADDRESS <br />PHILLIP M BROWN JR <br />915 W 3RD <br />GRAND ISLAND NE 68801 <br />UCC 1W <br />a Department of Revenue has camp : . with the revenue laws of the State of Nebras : in <br />rti91 release, or subordination Indicated above. <br />Revenue Agent 12/28/2016 (308)632 - 1210 <br />Title pate Telephone Number <br />Revenue Supervisor 12/28/2016 <br />Title Date <br />4- 232-68 Rev. 8.98 Supersedes 1432.69 Rey- 10-95 <br />p9s, 1 <br />1 'ILS <br />