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11/17/2004 17:31 FAX 14024714429 NEBRASKA UCC Z005/010 <br />s <br />li <br />200411220 <br />,,:3a AM <br />STATE TAX LIEN • NEBRASKA DEPARTMENT OF LABOR NDOL Office of Legal Counsel <br />P.O. Box 94600 <br />X RELEASE (PARTTAL) Lincoln, NE 68509 -4600 <br />Telephone - (402) 471 -9912 <br />FAX - (402) 471 -9917 <br />Employer Name: Ronald L. & Sharon R- Juracek, d/b /a Library Lounge <br />Address: 2012 W. Koenig Street, Grand Island NE 68803 <br />NDOL Employer Acct No.: 1 0221344006 <br />Federal ID No. / SSA No.: 147- 0529380 <br />This PARTIAL RELEASE serves to remove that portion of the property in the lien described below, but does not alter the lien priority <br />of the Nebraska Department of Labor on the affected property of this employer. This Partial Release is filed pursuant to <br />Neb. Rev. Stat. §48 -657, Neb. Rev. Stat. §48- 660.01, and the Uniform State Tax Lien Registration & Enforcement Act <br />(Neb. Rev. Stat §77 -3901, etseq.). <br />LIEN TO BE PARTIALLY RELEASED: <br />FULL Termination d 1 PARTIAL Release NDOL Serial No.: LAB- 0119 -1999 <br />Property description (ONLYif PARTIAL Release): State Tax Lien Document No.: 0895106336 <br />Lot Eight (8), Block Six (6), Woodbine Addition, and its County: Hall <br />complement, Lot Eight (8), Block Sixteen (16) , Wasmer Annex to County Document No. • 0895106336 <br />Grand Island, Hall County, Nebraska. Other Filing Information: Org, filed Co. <br />09/20/95 @11:16 #95- 106336, Cone UCC 9999841491 & <br />Co. on 08/19/99(x)8:00 #99- 108379 <br />I certify that the Nebraska Department ofLabor has complied with the Employment Security Law of the State of Nebraska in <br />the determination of the amount due, and the employer has failed to pay the amount due after demand. <br />FERNANDO LECUONA, III <br />Commissioner of Labor----- <br />Date: November 15- 2004 <br />RETURN FILED COPIES TO: Nebr. Dept. of Labor - LEGAL <br />P.O. Box 94600 <br />1 !—In. NV. 6MIO -A(.nn <br />4 74--N -sM -or- THOMAS A. UKINSKI <br />Legal Counsel Legal Counsel <br />NEBR. DEPT. OF LABOR'S <br />CHARGE ACCT. #14765 <br />