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06/01/2001 16:49 FAX 14024714429 NEBRASKA UCC [a 002 <br />T10 <br />200105278 <br />iisiii iii�iiiu - iiii� as <br />9901146010 Pfls 1 <br />PEDROZA .IOSEFINA <br />Filed 05101/2001 02 -56 PM <br />State Tax Lien Statement of Termination <br />Or or Certificate of Partial Release or <br />rag Subordination <br />ttrpanm mt <br />- <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Pursuant to the revenue laws or the State of Nebraska, notice Is hereby <br />given that the State Tax Lien which has been duly filed by the Nebraska <br />Department orRevenue against thebelow -named taxpayer,is terminated, <br />partially released, or subordinated to the extent indicated below. <br />Nebraska Identification Number <br />Tax category <br />Social Security or Federal I.D. Number <br />Spouse's Soda' Security Number <br />37304119 <br />22 <br />465 -33 -1543 <br />Lien serial Number <br />I Lien Filed With <br />Date of Lien <br />County <br />970110054 <br />0 Register of Deeds ❑ County Clerk <br />01-11-97 <br />HALL <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />Name <br />RICHARD $ JOSEFINA PEDROZA <br />StrsetAddraw <br />Street or Other Mailing Address <br />PO BOX 623 <br />city State ap code <br />city State Zip Code <br />WOOD RIVER NE 68883 <br />! TYPE OF ACTION I <br />®TERMINATION OF TAX LIEN. The State Tax Lien is thereby fully terminated_ INSTRUMENT NUUMBER °97- -101 -1 39•s 2- -20 -97 <br />0 97 <br />TAX YEARS (corporate, Individual income, and withholding tax only) _ f 77 <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 />Please return to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2"D ST STE 460 <br />GRAND ISLAND NE 68803 <br />Name of party making request and responsible for fling cedifieate of partial release or subordination with appropr!aie filing officer. <br />hereby oartify that the Nebraska Depatnent of Revenue has complied with the revenue laws of the State of Nebraska in the astermination of the <br />termination, partial release, or subo instion indleated above. <br />sign Z. (50105 B< ll 7 <br />here 2 par ers r Da Telephone No <br />f e <br />NEBRASKA DEPART OF REVENUE - White and Canary Copies TAXPAYER - Pink Copy COUNTY OFFICE - Goldenrod Copy <br />44232 -as Rev, 8-96 supersedes 4-232-68 Rev. 10• <br />