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08/31/2004 14:30 FAX 14024714429 NEBRASKA UCC IA 004 /006 r - 200408704 or State Tax Lien Statement of Termination or Certificate of Partial Release or Subordination i Type of Action - ......I XN TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. TAX YEARS (corporate, individual income, and withholding tax only) UCC Instrument Number `, �, County Instrument Number - `t0.0%8` —_ -' ' 1995, 1997 PARTIAL RELEASE. The State Tax Lien is partially released as follows: TAX YEARS (corporate, individual income, and withholding tax only) ❑ SUBORDINATION. The State Tax Lien is subordinated as follows. UCC Instrument Number County Instrument Number UCC Instrument Number County Instrument Number r I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in ennination f the terrain ion, partial release, or subordination indicated above. Sig n REVENUE AGENT 08/2712004 402 471 -5835 here Prep e s ignature Title Date Telephone Number thorized Signafture title mate 4- 232-68 Rev. 8-96 Supersedes 4- 232 -69 Rev. 10 -95 PLEASE DO NOT WRITE IN THIS SPACE Pursuant to the revenue laws of the State of Nebraska, notice is hereby given that the State Tax Lien which has been duly flied by the Nebraska Department of Revenue against the below -named taxpayer, is terminated, partially released, or subordinated to the extent indicated below. Nebraska Identification Number Tax Category Social Security Number Spouse's Social Security Number 39325725 22 613 -52 -6286 Lien Serial Number Lien filed with Date of Lien County 981980302 K Register of Deeds XD County Clerk 01/02/1999 HALL BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name Name SANTIAGO PEREZ Street Address Street or Mailing Address 517 S LOCUST ST City State Zip Code City State Zip Code GRAND ISLAND NE 68801 i Type of Action - ......I XN TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. TAX YEARS (corporate, individual income, and withholding tax only) UCC Instrument Number `, �, County Instrument Number - `t0.0%8` —_ -' ' 1995, 1997 PARTIAL RELEASE. The State Tax Lien is partially released as follows: TAX YEARS (corporate, individual income, and withholding tax only) ❑ SUBORDINATION. The State Tax Lien is subordinated as follows. UCC Instrument Number County Instrument Number UCC Instrument Number County Instrument Number r I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in ennination f the terrain ion, partial release, or subordination indicated above. Sig n REVENUE AGENT 08/2712004 402 471 -5835 here Prep e s ignature Title Date Telephone Number thorized Signafture title mate 4- 232-68 Rev. 8-96 Supersedes 4- 232 -69 Rev. 10 -95