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,l Jul. 17. 2018 3:44FM NE Secretary of State - UCC Nebraska Identification Number 96048808 Lien Serial Number 11550911 BUSINESS NAME AND LOCATION ADDRESS 201804589 � ,,,�„� State Tax Lien Statement of Termination or REVENUE Certificate of Partial Release or Subordination Pursuant to the revenue laws of the State of Nebraska, notice is hereby given that the State Tax Lien which has been duly filed by the Nebraska Department of Revenue against the below -named taxpayer, is terminated, partially released, or subordinated to the extent indicated below. Federal Identification Number Lien filed with Register of Deeds Social Security Number XXX -XX -8158 Data of Lien Tax Category 05/05/2015 22 Type of Action CODY T HORTON 1821 E CAPITAL AVENUE GRAND ISLAND NE 68801 Ni Set .r John A 0.1• - I i County HALL No.4844 F. 4 PLEASE DO NOT WRITE IN THIS SPACE TAXPAYER NAME AND MAILING ADDRESS 9918815948 - 7 PEI FiledN 07 10 :19 All NE91cxOiv utt-r ur ncvcivuc PO BOX 94609 LINCOLN NE 68509 -4609 Spouse's Social Security Number ® TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. UCC Instrument Numb�9915753810 TAX YEARS 2012 County Instrument Number 201502964 (corporate, individual income, and withholding tax only) Continuance: UCC Instrument Number Continuance: County Instrument Number ❑ PARTIAL RELEASE. The State Tax Lien is partially released as follows' TAIL YEARS (corporate, Individual Income, and withholding tax only) El SUBORDINATION. sign here Authorized Signature Title Revenue Supervisor Title UCC Instrument Number County Instrument Number The State Tax Lien Is subordinated as Follows. UCC Instrument Number County Instrument Number ereby certi r - the Nebraska - rtment o Revenue has compr :. wit the revenue laws o the determination of the termination partial release, or subordination indicated above. Revenue Agent 07/10/2018 Pale to o aska In (308)632 -1203 Telephone Number 07/10/2018 Date 4 - 22.89 Rev. 6.96 Supereeuee x232.69 Rev. 10.95