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<br />10/30/2006 17:35 FAX 14024714429
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<br />NEBRASKA uee
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<br />IaI 003/003
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<br />200609G99'
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<br />;llllllllrllIII
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<br />9906477801-2 Pss: 1
<br />JEWELL. GERAL.D
<br />, . FU.d: 10/SGI/201l16 03: 58 PM
<br />Please Return On1>LJ:I"'~ .....opy to me
<br />Nebraska Dept of Revenue at 200
<br />South Silber, North Platte, NE
<br />69101
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<br />If"
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<br />State Tax Lien Statement of Termination,
<br />or Certificate of Partial Release or
<br />Subordination
<br />
<br />riCltlUlO
<br />Cl"'....
<br />_r4'1'Wlt
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<br /> PLEASE DO NOT WRITE IN THIS SPACE
<br />Pursuant to the revenue laws ,of the State of Nebraska, no~ce is, hereby'
<br />gMm"that the State !ax'Llen ,which has been'duly-filed"by1he.N'ebras'ka,
<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 Social Security Number Spouse's Social Security Number
<br /> 37277235 351-62-9022
<br />Lien Serial Number.; , "_,:,:",. ,,' Lien fil~d wilh \- .. Date of. Lien T~ Category County "
<br />::- :',:', ,:,: '~982260Q3S" -" ,_ . :'~" I!J R:~'ist~; oi'l?~S 0 ~ounty-'ci~rk- .. . .~ ;"'-.. ... .,'
<br />10/01/1998 22 HALL' -,:):::''-;:::'' .-
<br /> I, f '. "_'. '.: _,...: .','. . - .' . .. ,-' - -
<br />I "3 ~ . 'BUS'U\lESS:IilJ\ME~'AND't:ocimolitADDRESS;, ''''C,/ ;';i;. ''-,:'' ' , :1',", ,TAXPAYER NAME AND MAILING ADDRESS
<br />" ' , --..
<br />BlIslneu"Name -,} ",', "' j ~':'~,. '. ~ ~. . . '1i.'.. .':~'~~::::>'~1 ~:~"'" ::~:,::..-: ,:.:>, :,;,'1 :".f~~:t.-,.~- 'N.ame: " " . ;:: ,':'; .:, -'. :.:' i. '. ~j l ~ ".: '. ", :'.
<br /> ~: , , ;...:....-, , "
<br /> ", . _.... J , '~J. ... .... ,........' ~ ,w._, ~ d'_
<br />..... r ...._,......,. ..... .., ~ ", ~ -, ~.... . ,...,. -... '" '" . , '... " GERALD JEWELL
<br />Slreet Address .. Slreel or Mailing Address " ..
<br />" ",
<br /> .. ' , ".....2323 BELLWOOD DR #52 .. - - .-
<br />City Slate Zip Code City Stale 'Zip Code
<br /> Gf{AND ISLAND NE 68801
<br />I Type of Action , _H..___--------.... I
<br />I!l TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. UCC Instrument Numbe.(' eB98110085 ......)
<br />~,
<br /> County Instrument Number 98 1100B5
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<br />TAX YEARS (corporate, Individual income, and withholding tax only)
<br />
<br />1990, 1994
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<br />o ' PARTIAL RELEASE.
<br />
<br />The Slale Tax Lien is partially released as follows:
<br />
<br />UCC Instrument Number
<br />County Instrument Number
<br />
<br />TAX YEARS (corporate, Individual Income, and withholding tax only)
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<br />D SUBORDINATION.
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<br />The State Tax Lien is subordinated as follows.
<br />
<br />ucc Instrument Number
<br />County Instrument Number
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<br />I" ~
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<br />,.-': .,..
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<br />, -, ,', ""C,,, I ,hereby certlfy..thaUhe .Nebraska Department, of ,Reve!lu.ehas, ,complied with the revenue laws ,of the State of Nebraska In
<br />"..~" ,,'" " _ d,~ lTT1inatjon 'oftne.ten;nination, partial,~Jease; or subordination indicated abo~e. .. , ,. .:"," ~ . .. ~ .'; : ":':>,' ,,:,'."":': " n, ,. '::::"';,:._ '
<br />sign .,.,,' - " '~L:"'" , ", " 'Re~en~~"AQ~nt' .. 7{/2l~'-'''' ..,_.. - -':..~ 308--535':829~r
<br />~::herf;f :', arar's Sign ur Title Date; ',' Teleplione Number'
<br />.... Revenue Senior Agent' / 0 ~ -tJ~ .
<br />Title Date
<br />4-232-68 Rev. 8.96 superaede$ 4-232..{j9 Rev, 10.95
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