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04/07/2004 08:59 FAX 14024714429 NEBRASKA UCC IA002 /004 <br />l <br />r <br />401�1+frtM►tI <br />or <br />Please return to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2ND ST STE 460 <br />GRAND ISLAND NE 68803 <br />I PM <br />TIS <br />State Tax Lien Statement of Termination <br />or Certificate of Partial Release.or <br />Subordination <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 />DO NOT WRITE IN THIS SPACE <br />20040338'7 <br />Nebraska Identification Number <br />Tax Category <br />Federal Identification Number <br />Social Security Number <br />01- 6168558 <br />01 <br />Lien Serial Number <br />Lien filed with <br />Date of Lien . <br />County <br />04/10/315 <br />XD Register of Deeds [] County Clerk <br />10/24/94 <br />L I— <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />Name <br />Sanitary Services, Inc. <br />Street Address <br />Street or Mailing Address <br />East Hwy. 30 <br />City <br />State Zip Code <br />City State Zip Code <br />Shelton NE 68876 <br />Type of Action <br />U TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. UCC Instrument Number Filed I ..2- /94-- - <br />County Instrument Number = 108672 <br />TAX YEARS (corporate, Individual Income, and withholding tax only) /6 7 <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. <br />UCC Instrument Number <br />County Instrument Number <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in <br />d e minatlon of the termina ion, parttal release, or subordination indicated above. i <br />sign Revenue Agent 03!22/2004 308 385 -6070 <br />here Preparer's Signature Title Date Telephone Number / <br />10� >I Taxpayer Services Supervisor 03/22/2004 <br />uthorized S' n t re Title Date <br />4- 232-60 Rev. 9-96 Supersedes 4- 232 -69 Rev. 10 -95 <br />