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<br />03/11/2008 TUE 15:41 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />~002/002 <br /> <br />of{) <br /> <br />Please forward to: <br />Nebraska Dept of Revenue <br />4500 Ave I PO Box 1500 <br />Scottsbluff. NE 69363-1500 <br /> <br />200802040 <br /> <br />Fiied: 03/11/2009 02:53 PM <br /> <br /> <br />~ <br />Nieb'''llka D""...~rt1:..f <br /> <br />REVENUE <br /> <br />lyIIII...,..w_~..-v."U1..f"'....V <br /> <br />State Tax Lien Statement of Termination or <br />Certificate of Partial Release or <br />Subordination <br /> <br /> PLEASE DO NOT WRITE IN ntlS SPACE <br />Pursuant to the revenue laws ofthe State of Nebraska, notfce 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 Identificatlon Number Federal Identification Number Social Security Number Spouse's Social Security Number <br /> 37140485 XXX-XX-9515 <br />Lien Serial Number Lien filed with Date of Lien Tax Category County <br /> .42890016 129 Register of Deeds D County Clerk 10/07/2005 Hall <br />1 BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Name . <br /> Lynda LOtt <br />Street Address Street or Mailing Address. <br />. , 415 S Cherry St Apt U4 <br />City State Zip Code City State Zip Code <br /> Grand Island NE 68801 <br />1- Type of Action 1 <br />DSI TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. UCC Instrument Number C 99054163017) <br /> County Instrument Number &VVvIUU,)":: <br /> <br />TAX YEARS (corporate, individual income, and withholding tax only) 2001 <br /> <br />o PARTIAL RELEASE. <br /> <br />The State Tax lien is partially released as follo~: UCe;: Instrument Number <br />County Instrument NumbE!r <br /> <br />TAX YEARS (corporate, individual income, jlnd 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 /> <br />I her y certify that the Nebraska Department of Revenue. has complied with the revenue laws of the State of Nebraska in <br />ation of the t rmination, partial release, or subordination indicated above. - <br /> <br />Revenue Agent <br />Title <br /> <br />03/04/2008 <br />Date <br /> <br />308632-1206 <br />Telephone Number <br /> <br />03104/2008 <br />Date <br />4-232-68 R.v. 8-9$ Supersedes 4.232-69 Rev. 10-95 <br /> <br />Revenue Supervisor <br />Title <br /> <br />(]J <br />