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05/12/2002 15:45 FAX 14024714429 <br />V% <br />Please forward to: <br />Nebraska Department of Revenue <br />4500 Ave I PO Box 1500 <br />Scottsbluff,IN'B 69363 -1500 <br />NEBRASKA UCC <br />200208528 <br />1a002/003 <br />IrState Tax Lien Statement of Termination <br />or Certificate of Partial Release or <br />naeruke , <br />°^•nt Subordination <br />W nvaem <br />PLEASE DO NOT WRITE IN THIS SPACE <br />pursuant to the revenue laws of the State of Nebraska, notice is hereby <br />given that the State Tax Lien which has been duly Bled by the Nebraska <br />DepartmentofRevenueagainstthebelow -named taxpayer, Is terminated, <br />partially released, or subordinated to the extent indicated below. <br />weorassa iaenancanon suri lu,;ategory Social Security or Fadoral l.D. Number Spouse's Soria! Se unty Number <br />32114176 22 484 -26 -0466 <br />Lien Sanal Number Len Filed Will I Date of Llen County <br />922830019 (N Register ofDi ❑CountyClark 02/04/1993 Idall <br />B USINFSS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS I <br />atainess New; Name <br />Jess Lot:eL' <br />Street Address Street or Other Nailing Address <br />610 W Qnadian <br />City Sate Zip Code Crry State Lpcoae <br />Vinita. OK 74301 <br />TYPE OF ACTION /�i' <br />EN TERMINATION TAX LIEN. The State Tax Lien is hereby fully terminated. INSTRUMEN UIwr 0 9 10 -a <br />(corporate, individual Income, and withholding tax only) 1934 1985 1986 r 198Cty#98 -10066 <br />❑ PARTIAL RELEASE. The State Tax Lien is partially released as follows. INSTRUMENT NUMBER <br />TAX YEARS (corporate, Individual income, and withholding tax only) <br />❑ SUBORDINATION. The State Tax Lien Is subordinated as follows. INSTRUMENT NUMBER <br />Name of party making reQUest and responsible ror filing Cerbfipate of parnai release or subordination with appropriate Fling officer. <br />I hereby testy mat the Rebroska Department of Revenue has complied with the rerenue laws of the State of Nebraska in the determinaflon of the <br />term nation, al release, or euaadinalion indicated aoave. <br />here . R ve Agen Z. �; <br />t ? 1308 )632 -1200 <br />"ere Pf° a - Cate plop a No <br />Revenue Supervisor 6 <br />Yid d sued Signature Tme — <br />DEPARTMENT OF REVENUE - White and Canary Copies TAXPAYER - Pink Copy <br />COUNTY OFFICE - Goldenrod Copy <br />.232 as Rev. "a supi 4-251z83 Ar.. 0.95 <br />c. <br />