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09/12/2005 16:54 FAX 14024714429 NEBRASKA UCC Q002/004 <br />�+v <br />Please return to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 1T ST STE 460 <br />GRAND ISLAND NE 68803 <br />tr <br />� rovNra� <br />20050896'7 <br />N9 see of s{.r. - UCC Te/ <br />I <br />i <br />9905411698 -1 Pss: 1 <br />WATERMAN CATHERINE <br />Filed: 09/12/2005 09:17 AM <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 />11255900 <br />Lien Serial Number Lien filed with <br />85326026 Lgs Register of Deeds N 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 <br />505 -34-0345 <br />Date of Lien Tax Category <br />11/22/1985 22 <br />Spouse's Social Security Number <br />506 -36 -7199 <br />County <br />Hall <br />TAXPAYER NAME AND MAILING ADDRESS <br />Name <br />Donald R. and Catherine Waterman <br />street or Mailing Address <br />624 North Webb Road <br />State Zip Code City State Zip Code <br />City 68801 <br />Grand Island NE <br />Type of Action <br />1. <br />p TERMINATIOTf OF`TAX LIEN. The State Tax Lien is hereby fully terminated. UCC Instrument Number'` -, ie <br />County Instrument <br />TAX YEARS (corporate, Individual Income, and withholding tax only) 1985 1 " / <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 certlty that the Nebraska Clap— rtm- of Revenue has complied with the revenue laws of the state oT Nebraska in <br />determination of the termination, partial release, or subordination indicated above. _ <br />9 Revenue Senior Agent q G 5 308 385 -6070 <br />sign � — Datg" �_. Telephone Number <br />Prepares Title here Revenue 5u ervisor ° <br />IP Title to <br />('_AuthorlzP&S1a re 4- 292.68 Rev. B -96 Supersedes 4 -2329 Rev. 10 -95 �� f <br />