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09/08/2000 14:14 FAX 14024714429 NEBRASKA UCC 0.002/004 <br />llllll�llllllll1111 {111111111tIINIh11H <br />9900077953 FOS <br />SIJANSON JAMES R <br />Filed 00123!2000 10.42 AM <br />Or <br />Mbfield <br />dep�rhMnt <br />of revenue <br />200007465 <br />State Tax Lien Statement Terminatio <br />or Certificate of Partial <br />Subordination <br />PLEASE DO NOT WRITE IN THIS SPACE <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 Med by the Nebraska <br />Department of Revenue against the below -named taxpayer, is terminated, <br />partially released, or subordinated tD the extent indicated below. <br />Nebraskaldanti&cation Number <br />6958583 <br />Tax Category <br />01 <br />Social Security or Federal 1,D. Number <br />505-06-7043 <br />Spouse's Social Security Number <br />Lien Serial Number <br />7/03/347 <br />Lien Fled With <br />Register of Deeds ❑ Courty Clerk <br />Date of Lien <br />03-16-1997 <br />County <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />Name <br />J <br />Street Addreao <br />Street or Other Mailing Address <br />PQ BOX 511 <br />City State <br />Zip Code <br />City State <br />TYPE OF ACTION <br />;GERMINATION OF TAX LIEN, The State Tax lien is hereby fully terminated. INSTRUMENT NUMBER <br />TAX YEARS (corporate, individual income, and withholding tax only) <br />03 -24 -1997 <br />❑ PARTIAL RELEASE. The State Tax Lien is partially released as follows. INSTRUMENT NUMBER <br />TAX YEARS (corporate, Individual income, and wflhholding tax only) <br />❑ SUBORDINATION. The State Tax Lien is subordinated as follows. INSTRUMENT NUMBER <br />Return to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2ND ST STE 460 <br />GRAND ISLAND NE 68843 <br />Name of party making requestand responsible for filing certificate of partial release or subordination with appropriate filing officer. <br />I hereby certify that the Nebraska Department of Revenue has Complied with the revenue laws of the State of Nebraska in fie determination of the <br />termination, partial ralease, or bordination indicated above . <br />sign <br />here f�repare�ssigreture Des Teiepho eNo. Des .01 <br />Auft Ir <br />N–E—BRASKXDEPAMMMT OF REV E - White and Canary Copies TAXPAYER - Pink Copy COUNTY OFFICE - Goldenrod Copy n^ <br />4 -W2.65 Fiev. 6.96 supersedes 4- 232 -M Rev..0-915` <br />