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09/30/2004 11:02 FAX 14024714429 NEBRASKA UCC <br />Or <br />nebraska <br />department <br />of revenue <br />200409050 <br />_ _ _- 002/003 <br />09:48 AM <br />Notice of State Tax Lien <br />PLEASE DO NOT WRITE IN THIS SPACE <br />aE 1TM STATE TAX LIEN <br />INDIVIDUAL INCOME TAX <br />IF Y €Q INQUIRE 'ABCUS'T YOUR <br />ACCOUN -Tv REFER TO THESE 10;- MB'ERS-0 <br />SOCi SEC. NOO 500-5 4 3490 <br />REBRi I 'DENT& NO- 15257924 <br />SPOUSE SOC. SEC- W1 3, <br />TAXABLE YEAR 1 9701199/ 19921 IF STEPHEN R BELTZER <br />LIEN NO* 96-2850052 3407 STA ECUACH RID <br />LIEN RELEASE NO- 042686637 GRAND ISLAWD ME 688CI <br />COUNTY HALL <br />DATE OF NUTICE 09/2. <br />I€STRtM€NT NO. CTY .ffi <br />PURSUANT TO THE REVENUE LAWS OF THE STATE OF NEBRASKAT NOTICE IS <br />HEREBY GIVEN BY THE . NEBRASKA 'DEPARTMENT OF REVEfk%F THAT THE <br />STATE TAIL LIEN W141CH HAS BEEN DULY FILIED AGAINST THE ABOVE NANIED <br />TAXPAYER FOR INDIVIDUAL I'NCOiNE TAXES IS TERMINATE -De <br />I HEREBY CERTIFY WHAT THE NEBRASKA <br />WITH THE REVENUE LAWS OF THE STATE <br />THTS TERMINATICN- <br />• i r • a i i i <br />FRE RIS SIGNAT�� /I TITLE <br />DE.PAFTNENT OF REVSNUE HAS (COMPLIED <br />OF NEBRASKA IN THE DETERPINATION OF <br />liilii!!i!i !i !i>I!i •lliii li <br />DATE <br />♦. l� .:. fii •li.i .i ! i . i+fai •.• .il ;eli.i K.i.iiii <br />TZEVSIGNA TURF TITTLE DATE <br />PLEASE RETAIN THIS NOTICE WITH YVUR PERMANENT RECORDS. .� <br />NEBRASKA DEPARTMENT OF REVENUE — White and Canary Copies TAXPAYER — Pink Copy <br />Printed with soy ink on recycled paper 7 -145 -7979 Rev_ 2 -2000 supersedes 7 -145 -1979 Rev. 10.,7985 <br />