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<br />03/03/2008 MON 15:03 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />~002/003 <br /> <br />~' <br />\:5 .. <br /> <br />20-0801756' <br /> <br />Please Return Original Copy to the <br />Nebraska Dept. of Revenue at 200 <br />, South Silber, North Platte, NE <br />69101 <br /> <br /> <br />~~.;:..~~.; <br />'REVENUE <br />'tN"~.r..\(.""".. t'Ir...8'W" <br /> <br />State Tax Lien Statement of Termination or <br />Certificate of Partial Release or <br />Subordination <br /> <br />Pursuant to the revenue laws of the State of Nebraska, notice Is hereby' <br />given thatthe 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 /> <br /> <br />T," <br /> <br />Nebraska Identification Numbar Faderal/dentification Number <br />15702928 <br /> <br />Social Security Number <br />XXX-XX-Q129 <br /> <br />9908550325-6 PSIS: 1 <br />WHITE ROBERT 1'1 <br />Flied:' 03/03/2008 02:22 P" <br />Spouse's Social Security Number <br /> <br />Lien Serial Number Lien filed with ' Date of Lien Tax Category County <br />913400198 (ZjRegister of Deeds DCounty Clerk 02106/1992 22 Hall <br /> <br />BUsiNESS NAME AND LOCATION ADDRESS , TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Name <br />Robert M White <br />Street or Mailing Address <br />909 W South'Front <br />City <br />Grand Island <br />Type of Action <br /> <br />[&I T~RMINATIONOF TAX LIEN. The State Tax Lien is hereby fully terminated. . <br /> <br />Street Address <br /> <br />City <br /> <br />State <br /> <br />Zip Code <br /> <br />State <br />NE <br /> <br />Zip Code <br />68801 <br /> <br />TAX YEARS (corporate,lndivlduallncome, and withholding tax only) <br /> <br />ucc Instrument Number <br />County Instrument Number <br />198419851986 <br /> <br />0896100974 <br />96'100974 <br /> <br /> <br />o PARTI~L RELEASE. <br /> <br />The State Tax Lien is partially released as follows; UCC 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 as follows, <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 h~s (;omplied with the revenue laws of the State of Nebraska in <br />det rmin,ation of the termination, partial release, or subordinatIon indicated above. ' <br /> <br />Revenue Agent <br />Title <br /> <br />Revenue Senior Agent <br />Title <br /> <br />d'dd-oR' <br />Dale <br /> <br />308 535-8:293 <br />Telephone Nurnber <br />d. ...;).~ -0 g- <br />Date <br />~:232-68 Rev. 6-96 SupecudQs 4-232-69 Rev. 10-95 <br /> <br />\L <br />