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01/14/2004 09:35 FAX 14024714429 <br />r14pi;titRR " - <br />dot+lii�tFt <br />atfar�rvio- <br />NEBRASKA UCC <br />200400409 <br />14(002 <br />N[ Sea of 54.40 - UCC Taf <br />I <br />i <br />i <br />8904311908 -5 Pos: t <br />GILL MILDRED <br />Filed: 01/09/2004 03:45 PM <br />State Tax Lien Statement of Termination <br />or Certificate of Partial Release or <br />Subordination <br />Type of Action ) <br />X� TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. UCC Instrument Number <br />County Instrument Number 8389 <br />TAX YEARS (corporate, individual income, and withholding tax only) 1995 <br />PARTIAL RELEASE. The State Tax Lien is partially released as follows: UCC Instrument Number <br />County Instrument Number <br />TAX YEARS (corporate, individual income, and withholding tax only) <br />SUBORDINATION. The State Tax Lien is subordinated as follows. UCC Instrument Number <br />County Instrument Number <br />I reby certif4thathe ebraska De partment of Revenue has complied with the revenue laws of the State of Nebraska in <br />d na 'o of tion, pa�ial lease, or subordination indicated above. ' <br />sign Revenue Agent 01/07/2004 402 595 -2067 <br />here - par S, u tie Date Telephone Number <br />Revenue Supervisor 01/07/2004 <br />uthorized Signatu Title Date <br />d_9T9_gA Rev R_qR Si ­r 84d d- 737 -69 Rev 10 -95 <br />A <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 filed by the Nebraska <br />Department of Revenue against the below -named taxpayer, is <br />terminated, partially released, or subordinated to the extent indicated <br />below. <br />Nebraska Identification Number <br />Tax Category <br />Social Security Number <br />Spouse's Social Security Number <br />38445719 <br />22 <br />103 -62 -5666 <br />307 -72 -6612 <br />Lien Serial Number <br />Lien filed with <br />Date of Lien <br />County <br />962430006 <br />Q Register of Deeds ❑ County Clerk <br />10/25/1996 <br />Hall <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name - <br />Name <br />Owen & Mildred Gill <br />Street Address <br />Street or Mailing Address <br />5004 Coachlight Dr <br />city State -Zip Code <br />City State Zip Code <br />West Des Moines IA 50265 <br />Type of Action ) <br />X� TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. UCC Instrument Number <br />County Instrument Number 8389 <br />TAX YEARS (corporate, individual income, and withholding tax only) 1995 <br />PARTIAL RELEASE. The State Tax Lien is partially released as follows: UCC Instrument Number <br />County Instrument Number <br />TAX YEARS (corporate, individual income, and withholding tax only) <br />SUBORDINATION. The State Tax Lien is subordinated as follows. UCC Instrument Number <br />County Instrument Number <br />I reby certif4thathe ebraska De partment of Revenue has complied with the revenue laws of the State of Nebraska in <br />d na 'o of tion, pa�ial lease, or subordination indicated above. ' <br />sign Revenue Agent 01/07/2004 402 595 -2067 <br />here - par S, u tie Date Telephone Number <br />Revenue Supervisor 01/07/2004 <br />uthorized Signatu Title Date <br />d_9T9_gA Rev R_qR Si ­r 84d d- 737 -69 Rev 10 -95 <br />A <br />