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12/17/2004 17:47 FAX 14024714429 NEBRASKA UCC _ —_ _ 0 004 <br />0� <br />Or <br />nebraske <br />department <br />afrevenue <br />IF YOU INQUIRE <br />ACCOUNT, REFER <br />•• . ■e w say.. ucc 1es <br />200412165 9904366262.0 <br />Fipad; 12/116 /2004 03:06 PM <br />Notice of State Tax Lien <br />PLEASE DO NOT WRITE IN THkS SPACE <br />TERMINATION OF STATE TAX LIEN <br />INDIVIDUAL INCOME TAX <br />ABOUT YOUR <br />TO THESE NUMBERS: <br />SOC. SEC. NO. 505228286 <br />NEBR. IDENT. N). 16925351 <br />SPOUSE SOC. SE--. NO. <br />TAXABLE YEAR 2001 ERMA E THAGARD <br />LIEN NO. 030450093 1419 W LOUISE ST <br />LIEN RELEASE NO. 043411152 GRAND ISLAND NE 68801 <br />COUNTY HALL <br />DATE OF NOTICE 12 �b/2(3a4 <br />INSTRUMENT NO. UCC �°L <br />INSTRUMENT NO. CT e.. <br />PURSUANT TO THE REVENUE LAWS OF THE STATE; OF NEBRASKA, NOTICE IS <br />HEREBY GIVEN EY THE NEBRASKA DEPARTMENT OF REVENUE THAT THE <br />STATE TAX LIEl WHICH HAS BEEN DULY FILED AGAINST THE ABOVE NAMED <br />TAXPAYER FOR INDIVIDUAL INCOME TAXES IS TERMINATED. <br />I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED <br />WITH.THE REVE10E LAWS OF THE STATE OF NEBRASKA IN THE DETERMINATION OF <br />THIS TERMINATION. <br />ti <br />... .: .... _ .. . ... <br />. - -- <br />DATE <br />PREPARE R NATURE TITLE <br />' DATE <br />AU ORI D SIGNATURE TITLE <br />PL ASE RETAIN THIS NOTICE WITH YOUR PERMANENT RECORDS. <br />