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07/19/2001,16:58 FAX 14024714429 <br />NEBRASKA UCC <br />r <br />1a002/002 <br />State Tax Lien Statement of Termination <br />or Certificate of Partial Release or <br />Subordination <br />_ TYPE OF ACTION _ I <br />TERMINATIO OF TAX LIEN. The State Tax Lien is hereby fully terminated INSTRUMENT NUMBER 97- <br />AX YEAR corporate, individual Income, and withholding tax only) 1994 ��� — t 3 <br />s <br />❑ PA RELEASE. Tito State Tax Lien is partially released as follows. INSTRUMENT NUMBER <br />TAX YEARS (corporate, Individual Income, and withholding tax anti) <br />❑ SUBORDINATION. The State Tax Lien is subordinated as follows. INSTRUMENT NUMBER <br />Pease forward to: <br />Nebraska Department of Revenue <br />4500 Ave I PO Box 1500 <br />Scottsbluff NE 69363 -1500 j <br />I - <br />Name of party making request and responsble for filing certificate cf partial release or subordination with appropriate tiling officer. <br />I hereby certify that the Nebraska Department of Revenue has oomplied with the rovonus laws of the State of Nebraska in the determination of the <br />ts! release, oreubordinrlticn Indicated above. sign Aaent 13061 b32 -1200 <br />here Re r e C 4– Datil Telephone <br />M Revenue Supervisor <br />ized Si Tide Dort <br />N SKA DEPARTMAT OF REVENUE - White and Canary Copies TAXPAYER - Pink Copy COUNTY OFFICE - Goldenrod Copy <br />4.232-ea Rev. 8.86 suoertedes 4-272-06 Rov, 10.96 <br />PLEASE DO NOT WRITE IN TINS 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 Med by the Nebraska <br />Department orRevenue against the below -named taxpayer, is terminated, <br />200107178 <br />partially released, or subordinated to the extent indicated below. <br />Nebraska Identilication Number <br />Tax Category <br />Social Security or Federal I.D. Number <br />Spouse's Social Security Number <br />22 <br />461 -51 -3950 <br />Lien Serial Number <br />Lien Filed INilh <br />Date of Lien <br />County <br />972270056 <br />® Register of Deeds ❑ Cournyclerk <br />08(1511997 <br />Hall <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />Name <br />Street Address <br />Street or Other Melling Address <br />20 Bay Blvd <br />City State Zlp Code <br />City State Zlp Code <br />–1 <br />Bluffs 1A 515171 <br />_ TYPE OF ACTION _ I <br />TERMINATIO OF TAX LIEN. The State Tax Lien is hereby fully terminated INSTRUMENT NUMBER 97- <br />AX YEAR corporate, individual Income, and withholding tax only) 1994 ��� — t 3 <br />s <br />❑ PA RELEASE. Tito State Tax Lien is partially released as follows. INSTRUMENT NUMBER <br />TAX YEARS (corporate, Individual Income, and withholding tax anti) <br />❑ SUBORDINATION. The State Tax Lien is subordinated as follows. INSTRUMENT NUMBER <br />Pease forward to: <br />Nebraska Department of Revenue <br />4500 Ave I PO Box 1500 <br />Scottsbluff NE 69363 -1500 j <br />I - <br />Name of party making request and responsble for filing certificate cf partial release or subordination with appropriate tiling officer. <br />I hereby certify that the Nebraska Department of Revenue has oomplied with the rovonus laws of the State of Nebraska in the determination of the <br />ts! release, oreubordinrlticn Indicated above. sign Aaent 13061 b32 -1200 <br />here Re r e C 4– Datil Telephone <br />M Revenue Supervisor <br />ized Si Tide Dort <br />N SKA DEPARTMAT OF REVENUE - White and Canary Copies TAXPAYER - Pink Copy COUNTY OFFICE - Goldenrod Copy <br />4.232-ea Rev. 8.86 suoertedes 4-272-06 Rov, 10.96 <br />