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<br />~-_.....---------~_. <br /> <br />14I 006/007 <br /> <br />04/19/2006 08:38 FAX 14024714429 <br /> <br />NEBRASKA Dee <br /> <br />CD~ <br /> <br />200603449 <br /> <br />""'1\1\' i. <br /> <br /> <br />, 9906446547-1 9 <br />}~d~O~~/13J2006 04,03 PM <br /> <br />~. <br /> <br /> <br />State Tax Lien Statement of Termination <br />or Certificate of Partial Release or <br />Subordination <br /> <br />"'cb~kDo <br />d~p.filmvilA <br />~~II/.O <br /> <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 filed by the Nebraska . <br />Department of Revenue against the t}elow.named taxpayer, is <br />terminated, partially released,' or subordinated to the exte~t indicated <br />below. <br />Nebraska Identification Number Federal Identification Number Social Security Number Spouse's Social Security Number <br /> 5260051 73 1389050 <br />Lien Serial NLlmber . Lien filedwllh ., Date tlf .LIen., Tax Category Counly <br /> , . 7/09/317 o Re~ister of D~eds' OtoLlnlY Cl~rk . . 9-10-1997 01/21/68 Hall <br /> d. . .L... . " <br />\.. .,' BUSINESS-NAME AND LOCATION ADDRESS' ~:: ""', ".TAXP.AY.ER NAME:A.ND MAILING ADDRESS <br /> '" ..,.- <br /> .,... <br />Business Name Name: "" .:' :; .;: ' ~;, - :.... ,.[ ..-, . <br /> TEA~' c6Ffp'. .:":\ :.. ;, .:_ ~ I . . .,. ... <br />.... OAK GROVE INN . . .. .j' , <br /> L _-", ,',' " <br />Street Address Street Dr Mailing I\ddress ' <. <br /> 3205 SOUTH LOCUST 2421 E SKELLY DRIVE, STE 110 <br />City Stale Zip Code City. , State Zip Code <br /> GRAND ISLAND NE 68802 TULSA . OK 74105 <br />r Type of Action I <br /> <br />TAX YEARS (corporate, individual income, and withholding taJl only) <br /> <br />UCC Instrument Number ,,_.."-~.---........ <br />county Instrument Num~: -1 07593_) <br />1996/1997 ..-------- <br /> <br />IKl <br /> <br />TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. <br /> <br />o PARTIAL RELEASE. <br /> <br />The State Tax Lien is partially released as follows: <br /> <br />UCC InstrLlment Number <br />County Instrument Number <br /> <br />TAX YEARS (corporate, Individual Income. and withholding tax only) <br /> <br />o SUBORDINATION. <br /> <br />The Stale Tax Lien is subordinated as follows. <br /> <br />UCC Instrument Number <br />County Instrument Number <br /> <br />Lien copy attached-recorded 9/15/1997 <br /> <br />Please return to: <br />STATE OF NEBRASKA' <br />DEPARTMENT OF REVENtJE <br />1811 WEST 2ND ST STE 460 <br />GRAND ISLAND NE Q8803 <br /> <br />sign ... <br />here <br />... <br /> <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the Stale of Nebraska in <br />del""';~'~' Jf the \f""eI~', ..rti.,..~.~. 0' '.'0";""'" "di"to' "0," . <br /> <br />~ \.fL- rdJ ~ Revenue Senior Agent .4 / /::Lj 0 b 308 385-6073 <br />Preparer's Signature '. Tille Date Telephone Number <br />Revenue Supervisor . t~ -}h> 6 <br />Title Djle <br />4-232.{jB Rev. B~96 Supersedes 4-232-69 Rev. 10.95 <br /> <br /> <br />SEE ATTACHMENTS <br /> <br />Q\ <br />