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061'13i2001 15:39 FAX 14024714429 NEBRASKA UCC <br />169 <br />Or <br />department <br />a' revenue <br />[a002/007 <br />NIL' 5uc of s1 / <br />11111" 111111 lll111111 09 <br />�llllIll9s. IIl1I <br />9901148783 p9s, 1 <br />51flVELY DARED E <br />Fil.d 06/1312001 11 01 RM <br />200105'702 <br />Notice of State Tax Lien <br />PLEASE DO NOT WRITE IN THIS SPACE <br />(T:ERPM:1INA:T1:0N a STATE TAX LIEN <br />D INCOME TAX <br />IF YOU INQUIRE ABOUT YOUR <br />ACCOUNTs REFER TO 'THESE NUMBERS2. <br />SOC+ SEC. NO- 503425678 <br />NEBR. IDENT+ N0+ 32578199 <br />SPOUSE SOC. SEC-.NO. 510443771 <br />TAXABLE YEAR 1996 DARELL E E TERRIE S SHIVELY <br />LIEN Na. 980440237 1002 SE 43RD-STREET <br />LIEN RELEASE ND. 011589540 CAPE CORAL FL 33904 <br />COUNTY WaA <br />DATE Of NOTICE 06/46/2001 <br />INSTRUMENT N0. �•`L -•�� � Ogq 2) b 300 <br />PURSUANT TO THE ..REVENUE LAWS OF NEBRASK.Ajv.NOTICE IS <br />HEREBY GIVEN BY THE NEBRASKA DEPARTMENT OF REVENUE THAT-THE <br />STATE TAX LIEN WHICH HAS BEEN DULY FILED AGAINST THE ABOVE:NAMED <br />TAXPAYER FOR INDIVIDUAL INCOME TAXES IS TERMINATED. <br />I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMENT Of REVENUE�HAS COMPLIED <br />WITH THE REVENUE LAWS OF THE STATE OF NEBRASKA IN THE DETERMINATION OF <br />THIS T RMINATION• <br />PREP S S E DATE <br />•• + •••.••.• ... • • • }..++ tea+++ .• +� <br />AUTHO ED SZ6NATURE TITLE DATE <br />Please forward to: <br />Nebraska Department of Revenue <br />4500 Ave I PO Box 1500 <br />Scottsbluff NE 69363 -1500 <br />ENT of REVENUE— White and Canary Copies TAXPAYER —Pink Copy <br />7.145 -1979 Rev. 2-2= SuPersedas 7- 145.1979 Rev- 1 C•1995 <br />