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<br />07/01/2008 TUE 15:18 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />121002/004 <br /> <br />Dt\J <br /> <br /> <br />990a564402-6 Pgs: 1 <br />KEEZER CHAD <br />Filed: 07/01/2008 08:40 AM <br /> <br />200805660 <br /> <br /> <br />~ <br />Neb:...."; DlII'..\'I",..1Tt 01 <br />REVENiUE <br /> <br />'tN\MI'W'.~.Y."""..""..,,~ <br /> <br />State Tax Lien Statement of Termination or <br />Certificate of Partial Release or <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 taxpayer, is <br />terminated, partially released, or subordinated to the extent indicated <br />below. <br />Nebraska Identification Number Federalldenlification Number Social Security Number Spouse's SOCilill Security Number <br /> 32065345 xxx~xx-4428 <br />Lien Serial Number Lien filed with Date of Lien Tax Category County <br /> 43450090 00 Register of Deeds 0 County Clerk 04/27/2005 22 HALL <br />I BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Name <br /> CHAD KEEZER <br />Slreet Address Street or Mailing Address <br /> 909 W SOUTH FRONT ST APT 2 <br />City State Zip Code City State Zip Code <br /> GRAND ISLAND NE 68801 <br />I Type of Action I <br /> <br />;r,; <br /> <br />~ TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. <br /> <br />UCC Instrument Number <br />County Instrument Number <br /> <br />9905391898-0 <br />200503811 <br /> <br />TAX YEARS (corporate, Individual income, and withholding tax only) 2001 <br /> <br />D 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 />D SUBORDINATION. <br /> <br />The State Tax Lien is subordinated as follows. <br /> <br />UCC Instrument Number <br /> <br />County Instrument Number <br /> <br />I hereby rtify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in <br />determina' n of the termination, partial release, or subordination indicated above. <br /> <br />sign <br />here - <br /> <br /> <br />Revenue Agent <br />Title <br />Rev Agent Supervisor <br />Title <br /> <br />06/27/2008 <br />Date <br /> <br />e <br />4-232~& Rev. 8-96 Suparsede$ 4--232~9 Rev. 10-95 <br /> <br /> <br />IA /1 W (1\ t..A.e-U <br />