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<br />03/05/2007 MON 17:08 FAX 402 471 2530 secofstate/licensing div
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<br />~ 003/008
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<br />HE 5.1f: O'f St.t:o Ja"n fI li,t,lD . lICe: TillS:
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<br />200'7'0169'8
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<br />11907498607-7 pg..., 1
<br />BERVERS CARRJE 0,
<br />Filed; 03/05/2007 10:42 AM
<br />Plea.<:e Return Original Copy lo the
<br />Nebra.ska Dept. of Revl.:n\le at 200
<br />South Silber, North Platte, NB
<br />69101
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<br />State'Tax Lien Statement of Termination
<br />,qr Certificate of Partial Release or
<br />Subordination
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<br />".p..rl>1lGnl
<br />9,1 'l).VC<1~,g
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<br />, , PLEASE DO NOT WRITE IN THIS SPACE
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<br />Pur$uant tathe revenue,laws'ofthe StatG, ofNebras~a, notice isheieby
<br />given that the State Tax Lien which has been duly tiled by the Nebrask'a
<br />Department of Revenue against the below~named taxpayer', il:i
<br />terminated, partially relea!ii@d, or subordinated to the extent indicated
<br />below.' " ' , " ','
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<br />Nebraska IdBntificationNumliOlr ,,: FedeiOlPldehtiflcation NLimber'
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<br />36362328 ,,:"':'
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<br />, Soci;:iI'Security Nur:nbGr
<br />, 508-86-4956
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<br />-Spouse's Social Sccwily NlIrlllJ~r
<br />506~96-0930
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<br />Lien Serial Number,' , Lien filed with _,
<br />40440344 ",:"" '[2gRegiste'ofD~d~ 'OC~;J!IIYCillrk
<br />'," .'. ..! - -. .:,.,'"", "". ,,',,",' . I
<br />BUSINESS I'(AM'E; ~j.JD LOCATION ADDRESS,
<br />Busllless Name "
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<br />Datebf lien '
<br />'O~/O~/26'05,
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<br />Tax Category County
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<br />22
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<br />HALL
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<br />TAXPAYER NAME AND MAILING ADDRESS
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<br />City
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<br />Slate
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<br />, Zip COde,
<br />
<br />Name
<br />RUSTIN'O & CARRIE 0 BEAVERS
<br />Street or Mailing Aildre~~
<br />',1~008 COSNER RD
<br />, City'
<br />AUBREY
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<br />SIiMl
<br />TX
<br />
<br />Zip Code
<br />73223
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<br />Street Address
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<br />
<br />Type of Actlon
<br />[ZJ TERMINATION OF TAX LIEN, The SlaleTax Lien is ~erebyfullylefmlnall;'l(l.
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<br />TAX YEARS (carporatfl, i...di~idual inc'ome., ~n~ withholding tl:X onlY), ' 2000
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<br />UCC Instrumerlt Number C 99054Q,~)
<br />COUrlly Irt:tltrum""lt Number 200507791
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<br />D PARTIAL RELEASE,
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<br />'The Stafe r.ax Lien 15 partially released as follows:
<br />
<br />ucc: Instrument Number
<br />"Ca'unly InstrumBnt NumbBr
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<br />. ".:, - ,".. .". .~~.. . . ." p.', I, _ .',. ,. ';:,. . ~ . .' .,. ,-': .'~; ",/
<br />TAX YEARS (corporate, individual income';a,nd witl>hQ1lling tllX only).
<br />
<br />D SUBORDINATION.
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<br />" 'The State Tax Lien is'"subordinallld ~s fllllowt;:
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<br />, UCC hJ5trument Number.
<br />, . . .
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<br />CQun~y In-5trument Number
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<br />308 535-8250
<br />Tl;ll!lpb"n", Number
<br />, ? ...;1"'07
<br />, Date
<br />, 4-ltn.BI) Il"". (l..M 'l"PCI";\'QO$ 4-?n-e~ flov, Ill-US
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