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<br />08/27/2007 MON 16:51 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />121003/006 <br /> <br />t>C\ <br /> <br />200707362 <br /> <br /> <br />9907!523144-7 pgs: 1 <br />SKILES RHONDA S <br />Filed: .08/27/2007 10:58 AM <br /> <br />ar <br /> <br />State Tax Lien Statement of Termination <br />or Certificate of Partial Release or <br />Subordination <br /> <br />noblfot~ <br />4.,...._ <br />0( ,.YOmlO <br /> <br /> PLEASE DO NOTWRlTE 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 below-named taxpayer, is <br />. terminated, partially released, or subordinated to the extent indicated <br />. below. <br />Nebraska :Identification Number Tax Category Social Security Number Spouse's Social Security Number <br /> . 32591276 22 508-04-3410 508-86-7953 <br />Lien Serial Number Lien filed with Date of Lien County <br /> :062511245 ~ RegIster of Deeds D County Clerk 03/30/2007 Hall. <br />I . BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Name <br /> Travis K and Rhonda S Skiles <br />Street Address Street or Mailing Address <br /> 4247 Spur Lane <br />City State ZIp Code City State Zip Code <br /> Grand Island NE 68803 <br />I Type of Action l <br /> <br />IKl TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully tennlnated. UCClnstrument Number ~907~030794 <br />. County Instrumei1t~Nl"mheF-.:...4Q~-..c~---. . "_...c,~~,-"_,",,_, . <br /> <br />TAX YEARS (corporate, individual Income. and withholding laX only) 2005 <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 laX only) <br /> <br />o SUBORDINATION. <br /> <br />The State Tax Lien is subordinated as follows. <br /> <br />Please forward to: <br />NebraskaDept of Revenue <br />4500 Ave I PO Box 1500 <br />Scottsbluff, NE 69363~1500 <br /> <br />UCC Instrument Number <br />County Instrument Number <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 State of Nebraska in <br />determination of the termination, partial release, or subordination indicated above. <br /> <br />~~ 1Jl -l. <br />-aalu..- <br />'flA ':iJp~ <br />Authorired ignalure <br /> <br />TSS II <br />Title' <br />Revenue Senior AQent <br />Title <br /> <br />V/~tJ1 <br />Date <br /> <br />308 632-1200 <br />Telephone Number <br />g I:J.:J. / ;J1YJ1 <br />Date <br />4-232-$8 Rev. 6-96 Supersedes 4-232-69 RllI/. 10-95 <br /> <br />(~ <br />