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03/15/2005 17:04 FAX 14024714429 NEBRASKA UCC 002 /003 we SM M 54.4e - UCC T ®9 990S.T84240 —$ Pas: 2 WGER DONNA M. F11ed: 09/16/2006 01:419 PM 200502232 State Tax Lien Statement of Termination or Certificate of Partial Release or Subordination PLEASE DO NOT WRITE IN THIS SPACE 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. Nebraska Identification Number Federal Identification Number Social Security Number Spouse's Social Security Number 6364055 507 -76 -2114 Lien Serial Number Lien filed with Date of Lien Tax Category County 1/05/874 0 Register of Deeds []County Clerk 5 -15 -1991 94 Hall BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name Name Street Address S Ms. Donna M. Barger treet or Malling Address 2703 South Engleman Road City State Zip Code City State Zip Code Grand Island NE -68801 Type of Action TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. UGC Instrum t N TAX YEARS (corporate, Individual income, and withholding tax only) _ ❑ PARTIAL RELEASE. The State Tax Lien is partially released as follows: TAX YEARS (corporate, individual Income, and withholding tax only) ❑ SUBORDINATION. The State Tax Lien is subordinated as follows. en umber 0$91102992 County Instrument Number 91- 5r.55_ - 97 UCC Instrument Number County Instrument Number UCC Instrument Number County Instrument Number I hereby certify that the Nebraska Department of Revenue has complied with the revenue determination of the termination, partial release, or subordination indicated above, in sign 402 471 -5709 here pre rer's Sign a Titte Date Telep one umber Revenue Senior Agent t r Ig ure Title a e 4 -232.0 Rev. B -B6 Supersodez 4 -232 -69 Rev. 10-95 SEE ATTACHMENTS I