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06/26/2003 17:06 FAX 14024714429 NEBRASKA UCC Q002/004 V P1.1 r eoi�arai�i arNO" 200308260 State Tax Lien Statement of Termination or Certificate of Partial Release or Subordination Pursuant to the revenue laws of the State of Nebraska, notice Is hereby given that the State Tax Lien which has been duly filed by the Nebraska Department of Revenue against the below -named taxpayer, is terminated, partially released, or subordinated to the extent indicated below. IN THIS SPACE Sociai Security Number Spouse's Social Security Numoer Nebraska Ident!ficat3on Number Tax Category 506-94 -1708 25301152 22 506- 84-7B54 Date of Lien County Lien Serial Number Lien filed with Hall 922480073 FXX Register of Deeds ❑ County CledC 11/03/1992 BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name "- Kevin &Bonnie Rush Street Address Street or Mailing Address 1100 G Caldwell Dr State Zip Code City State Zip Cod City I- IPnh7lhah GA 30815 Type of Action nX TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. UCC Instrument Numb 892109796 r County Instrument Numberc�2- - 109704 TAX YEARS (oorpornte, Individual income, and withholding tax only) 1969 19901991 PARTIAL RELEASE. The State Tax Lien Is partially released as follows: UCC Instrument Number County Instrument Number TAX YEARS (corporate, individual income, and withholding tax only) E] SUBORDINATION. The State Tax Lien is subordinated as follows. UCC Instrument Number County Instrument Number tAuth, certify that the Nebraska Department of Revenue has complied with the revenue taws or me otaie v, rvcu�aana n of the rmination, l release, or subordination indicated above. Revenue Agent Date --2003 402 595 -2067 sign � _Tie "paw Telephone umber here 061241200.3 avenue Su ervisor pate ipnature Title 6. 232 -66 Rev. 6 -86 SuperSedes 4- 292 -68 Rev. 10 •95