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12/21/2001 17:09 FAX 14024714429 NEBRASKA UCC Z002/002 <br />o� <br />200113382 <br />No S— sf Gi.i• IICC Tee <br />0201 4231 -3 <br />ODOM DAWN R <br />Fl led: 12121/2001 02:58 PM <br />State Tax Lien Statement of Termination <br />Ir or Certificate of Partial Release or <br />mbruka <br />daparUnant wwa Subordination <br />UT Fgv- <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 againstthe below named taxpayer, is terminated, <br />partially released, or subordinated to the extent Indicated below. <br />Nebraska identification Number <br />Tax Category <br />Social Security or Federal I.D. Number <br />Spouse's Social Security Number <br />39371247 <br />22 <br />250 -94 -0842 <br />478 -82 -1827 <br />Lien Serial Number <br />Lien Filed Wlth <br />Date of Lien <br />County <br />982260022 <br />®FiegisterofDeeas ❑county clerk <br />05 -07 -01 <br />HALL <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />None <br />JAMES E & DAWN R ODOM <br />Street Address <br />Street or Other Mailing Address <br />3619 BRONCO RD <br />City State Zip Coca <br />City State Zp Code <br />GRAND ISLAND NE 68801 <br />TYPE OF ACTION <br />TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully lenttinated. INSTRUMENT NUMB <br />TAX YEARS (corporate, individual Income, and withholding tax only) 1997 <br />❑ PARTIAL RELEASE. The State Tax Lien is partially released as follows. INSTRUMENT NUMBER <br />TAX YEARS (corporate, Individual Income, and withholding tax only) <br />❑ SUBORDINATION. The Stale Tax Lien is subordinated as follows. INSTRUMENT NUMBER <br />Please return to: <br />STATE OF NEBRASKA <br />DEPART LENT OF REVENUE <br />1811 WEST 2 "D ST STE 460 — — <br />GRAND ISLAND NE 68803 <br />Name o, party making request and responsible for filing certificate of partial release or subordination with appropriate Ung officer. <br />lb eby cars fy that the Nebraska Departmeht of Revenue has compiled wfth the revenue laws of the State of Nebraska in the determination of the <br />termin , n, partial release, or subordination Indicated above. <br />sign -Q Lcal - <br />here reparof'ssiWature Title Date Telephone No. <br />zed g <br />NEBRASKA DEPARTNERT OF REVENUE rte and Canary Copies TAXPAYER Pink Copy COUNTY OFFICE - Goldenrod CON <br />4.232.68 Rev, 8.96 SuMsedas 4- 252.08 RN. t <br />