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<br />05/30/2006 16:19 FAX 14024714429
<br />
<br />NEBRASKA Dee
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<br />14I 006/006
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<br />---
<br />
<br />\)~
<br />
<br />Please return to:
<br />STATE OF NEBRASKA
<br />DEPARTMENT OF REVENUE
<br />1811 WEST 2ND ST STE 460
<br />GRAND ISLAND NE 68803
<br />
<br />200604829
<br />
<br />II II Irll'Ihl'. - ~ '"
<br />_.4~~ 1111
<br />
<br />
<br />E~DER WILLIRM J PSI: 1
<br />FIled: 05/30/2006 02:49 ~
<br />
<br />...t~
<br />
<br />IIr
<br />
<br />
<br />State Tax Lien Statement of Termination
<br />or Certificate of Partial Release or
<br />Subord'ination
<br />
<br />~rtskao
<br />dlIpirtmOld
<br />ot~...
<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 bas been duly filed by the Nebraska
<br />Department of Revenue against the below-named taxpayer, is
<br />terminated, partiaily released, or subordinated to the extent indicated
<br />below.
<br />Nebraska Identification Number Federal Identification Number Social Security Number Spouse's Social Security Number
<br /> 6169317 ..-, 512-46-6359
<br /> " . .
<br />Lien Serial Number ' .. Lien fil,ed, ~i'h .., ... . D~te of Lien,.., ' ' " Tax, Category .. County
<br /> ,. .
<br /> " ~, .. .. .,
<br /> 08/09/314 ,. [!) Register of Deeds D C.ol;lnty ~Ierk '09i25/98 . .', .., 21' - _ n. . , , ., Hall
<br /> -", ' , .. ,
<br /> . ..
<br />I" ,. - BUSINESS NAME,AND, LOCATIO/ll ADDRESS. TAXPAYER NAME AND MAILING'A'tmRESS '.. ... ".
<br /> .. . ...
<br />Business Name"....... .'....d ,.i. . Name -. ..
<br />..... -OJ " ... ." '.or, . . "" ..".'.'.~'"
<br /> - ... .," ..
<br /> William TElder.... , .., -. d. -,..... . ",
<br />. , .
<br /> .., ..
<br />Street.Adcltess Street or M,ailing-'Address ..
<br /> " 656 Swan Lake
<br /> ' .
<br />City Staie Zip Code City State . Zip Code,
<br /> Grand Island NE ,68801
<br />I Type of Action .._,u-....._~~. .~ ' 'I
<br />
<br />~ TERMINATION OF TAX LIEN. The State Tax Lien is bereby fully tenninated,
<br />
<br />uee Instrument Number ~81()'7 0.30 ':")
<br />County Instrument Number,," 98-109630---'
<br />
<br />TAX YEARS (corporate, Individual income; and withholding tax only) '1996
<br />
<br />o PARTIAL RELEASE.
<br />
<br />The'State Tax Lien is partially released as follows:
<br />
<br />uce Instrument Number
<br />County Instrument Number
<br />
<br />. TAX YEARS (corporate, IndiVidual income, and.withholding.tax only)
<br />
<br />o SUBORDINATION.
<br />
<br />The State Tax Lien is subordinated asJollows,
<br />
<br />uee Instrument Number
<br />, County Instrument Number
<br />
<br />" .;:1'
<br />
<br />'... "I 0""
<br />
<br />'"
<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 Slale of Nebraska in,
<br />detennination of the ter ination, panial release, or subordinallon indicated above, ' , ' '
<br />
<br />67Cl (p I <ilOtJ6
<br />Dale
<br />Sel") iDf" ~en \-
<br />
<br />
<br />Revenue Senior Aqent '
<br />Tille
<br />Revenue
<br />Title
<br />
<br />308 385-6073
<br />Telephone Number
<br />57~~ jaooh
<br />
<br />Date . aD
<br />~-232-e9 R"v, 8-96 Supersed... 4-232-89 Rev lG-95 \
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