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04/07/2005 09:09 FAX 14024714429 NEBRASKA UCC <br />IM 004/005 <br />20050305' <br />State Tax Lien Statement of Termination <br />or Certificate of Partial Release or <br />Subordination <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 flied by the Nebraska <br />Department of Revenue against the below -named taxpayer, Is <br />terminated, partially released, or subordinated to the extent indicated <br />below. <br />Nebraska Identification Number <br />Federal Identification Number <br />Social Security Number <br />Spouse's Social Security Number <br />6490557 <br />449 -25 -4680 <br />Lien Serial Number <br />Lien filed with <br />Date of Lien <br />Tax Category <br />County <br />3/09/420 <br />❑x Register of Deeds ❑ County clerk <br />9 -30 -93 <br />94 <br />Hall <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />Name <br />Antonio Lopez <br />Street Address <br />Street or Mailing Address <br />1 822 East 7th St <br />City <br />State Zip Code <br />City State <br />Zip Code <br />Grand Island NE <br />68801 <br />Type of Action 4e G 7 <br />TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. UCC Instrument Number 0898100222 <br />County Instrument Number f$ - 100124 <br />TAX YEARS (corporate, Individual income, and withholding tax only) <br />❑ PARTIAL RELEASE. The State Tax Lien is partially released as follows: UCC Instrument Number <br />County Instrument Number <br />TAX YEARS (corporate, individual income, and withholding tax only) <br />❑ SUBORDINATION. The State Tax Lien is subordinated as follows. UCC Instrument Number <br />County Instrument Number <br />I hereby certify that the Nebraska Department of Revenue has compiled with the revenue laws of the State of Nebraska in <br />determination of the termination, partial release, or subordination indicated above. <br />Sign 10. 402 471 -5709 <br />here Preparses Signat Title Date Teleph jeNZuu,bm <br />Revenue Senior Agent <br />th e i re Title Date <br />r <br />4- 232.68 Rm. 8.96 Supersedes 4- 232 -69 Rev. 16.95 <br />r40Q� <br />