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07/06/2005 16:10 FAX 14024714429 NEBRASKA, UCC <br />M010 <br />w <br />orrovonai� <br />2 D0AXejo1G,123 <br />0003 /003 <br />.0 pr si.�� <br />. Te9 <br />Hi : ucc <br />9905402217 —Z P9*' 1 <br />BENNER BRADLEY T <br />Falad: 07/06/2005 10:49 RM <br />State Tax Lien Statement of Termination <br />or Certificate of Partial Release or <br />Subordination <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 filed 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 Federal Identification Number <br />28101219 <br />Lien Serial Number Uen filed with <br />30450343 0 Register of Deeds ❑ County Clerk <br />BUSINESS NAME AND LOCATION ADDRESS <br />Business Name <br />Street Address <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Social Security Number Spouse's Social Security Number <br />508 -96 -3287 <br />Date of Lien Tax Category County <br />11/24/2004 22 HALL <br />TAXPAYER NAME AND MAILING ADDRESS <br />Name <br />BRADLEY T BENNER <br />Street or Mailing Address <br />249 SOUTH VINE ST <br />city <br />State Zip Code City State — <br />NE <br />Zip Code <br />68801 <br />GRAND <br />ISLAND <br />Type of Action <br />-The fully terminated. <br />UGC Instrument Number <br />904362944-2 <br />V 'Y <br />`_, <br />Tj(iMINATION .OF" tAX, LIEN:. State Tax Lien is hereby <br />County Instrument Number <br />200411575 <br />TAX YEARS (corporate, Individual income, and withholding tax only) 2001 <br />PARTIAL RELEASE. The State Tax lien is partially released as follows: <br />UCC Instrument Number <br />County Instrument Number <br />TAX YEARS (corporate, Individual Income, and withholding tax only) <br />SUSORDINAT10N. The State Tax Lien is subordinated as follows. <br />UCC Instrument Number <br />County Instrument Number <br />sign 110. <br />here <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in <br />nartial releaR6. ar subordination Indicated above. <br />Revenue A ent 7-52005 402 471 -5835 <br />Title Date Telephone Number <br />Revenue Senior Agent pate <br />Title <br />4- 232 -68 Rev, 8-98 Supersedes 4-232 -69 Rev. 10-95 /' <br />