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<br />Please retum to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2ND ST STE 460 <br />GRAND ISLAND NE 68803 <br /> <br />Hall 121003/007 <br /> <br /> <br />\1111111111' <br /> <br />9908556033-3 Pgs. 1 <br />~IY:a~Y 0~~~~12008 11: 29 RI'I <br /> <br />04/15/2008 TUE 15:02 FAX 402 471 4429 UCC SECRETARY OF STATE 4~~ <br /> <br />o<fJ <br /> <br />200803139 <br /> <br /> <br />~ <br />to.:..b........ D""""'''''"M .._ <br /> <br />REVEN'UE <br /> <br />~wW."ri'.....,.~ti'. r.... .." <br /> <br />\ <br />State Tax Lien Statement of Termination or <br /> <br />Certificate of Partial Release, or <br /> <br />Subordination <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 which has been duly filed by the Nebraska <br />Department of Revenue against the below-named taxp.Y,er. is <br />terminated, partially released, or subordinated to the extent indicated <br />below. <br />Nebraska Identification Number Federal Identification Number Social Security Number Spouse's Social Security Number <br /> 8265909 xxx-xx-2849 <br />Lien Serial Number Lien filed with Date of Lien TalC Category County <br /> 9/11/361 1:&1 Register of Deeds DCounty Clerk 11/2'7/1999 01 Hall <br /> . .. <br />I BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Name <br /> Danny Medberry, <br />Street Address Street or Mailing Address <br /> 404 N Grace <br />City State Zip Code City State Zip Code <br /> Grand Island NE 68801 <br />I Type of Action . I <br />!1J.:teRMINATlON OF TAX LIEN. The State Tax Lien is hereby fully terminated. UCC Instrument Numbe09'9 1926599:, <br /> <br />County Instrument Number <br /> <br />99 111595 <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: 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 />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in <br />determ~ of the ter~ation, partial release, or subordination indicated above. <br /> <br />~ f . Revenue Agent 1:'1(~ $" 85-6073 - <br />Preparer's Signature Tille Date Telephone Number <br /> <br />Revenue Supervisor - D'f('~~ <br />Tille <br /> <br /> <br />4-232~8 Rev, /1.96 SUpersedes 4-232~9 Rev. 1()..9S <br /> <br />~ <br />