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<br />08/02/2007 THU 14:54 <br /> <br />FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />121002/002 <br /> <br />C)Cu <br /> <br />200706635 <br /> <br />111111111'1 III <br /> <br /> <br />9907519657-8 Pgs: 1 <br />BURRIS GARY <br />Filed: 08/02/2007 02:32 PM <br /> <br />_r <br /> <br /> <br />State Tax" Lien Statement of Termination <br />or Certificate of Partial Release or <br />. Subordination <br /> <br />n~!@Jt.. <br />\lOlNll1l'1'1O(\l <br />OJ rtvto. <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 whict) 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 Tax Calegory Social Security Number . Spouse's Social Security Number <br /> 5443687 1 512-42~7018 <br />lien Serial Number Lien flied with . Date of Lien County <br /> 120060342 o Register of Deeds 0 County Clerk 09/22/2006 Hall <br />I BUSINESS NAME AND LOCAl'lON ADDRESS TAXPAYER NAME AND MAILtNG ADDRESS <br />Business Name Name <br /> Gary Burris <br />Street Address Street or Mailing Address <br /> 2021N Sherman <br />City State Zip Code City State Zip Code <br /> Grand Island NE 68801 <br />I Type of Action I <br /> <br />[!] TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. <br /> <br />UCC Instrument Number 9906474532-8 <br />County Instrument Number 200609105 <br /> <br />TAX YEARS (corporate, individual income, and withholding tax only) <br /> <br />o PARTIAL RELEASE. <br /> <br />The State 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) <br /> <br />D. SUBORDINATION. <br /> <br />The State Tax lien is subordinated as follows. <br /> <br />UCC Instrument Number <br />County Instrument Number <br /> <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in <br />determination of the termination, partial r/;llease. or subordination indicated above. <br /> <br />sign .. <br />here <br />... <br /> <br /> <br />Title <br /> <br />Revenue Senior Agent <br />Title <br /> <br />Date <br /> <br />402 471-5709 <br /> <br />T1h?JL N,mbm <br />e I; 09 <br />Os ~ <br />4.232-68 Rev. 8.96 Supersedes 4-232..{19 Rev. 10-95 \'<d5 <br />