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10/13/2005 16:45 FAX 14024714429 NEBRASKA Dee 141 003/003 , Please return to: _'STATEOFNEBRA8KA DEPARTMENT OF REVENUE , 1811 WEST 2ND 8T STE 460 , GRAND ISLAND NE 68803 [1][1[11" I~ I C~pp ALBERT PQs: 1 _ Fll.~: _!0/11/2005 10:22 AM cY 200510203 '" State Tax Lien Statement of Termination or Certificate of Partial Release or Subordination ,.~t.lib /lO~ll4 ~I'O"OftWl PLEASE DO NOT WRITE IN THIS SPAC!= Pursuant to the revenue laws of the State of Nebraska, notice is hereby given that the State Tax Lien which has been duly filed by the Nebraska Department of Revenue against the below-named taxpayer, Is terminated, partially released. or subordinated to the extent indicated below. Nebraska Identification Number Federal Identification Number Social Security Number- Spouse's Social Security Number 7403100 ~ 512-42-4250 Lien Serial Number -_ Lien flied with _ Date of Lien Tax Category County 6/08/345 - o Register of Deeds 0 County Clerk 08/08/1996 Hall I BUSINES~'NAMEAND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name Name Albert Copp Street Address Street or Mailing Address 111 N Walnut City State Zip Code City State Zip Code Grand Island NE 68801 I Type of Action l o TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. . UCC Instrument Number coun~lnsuumentNumb~~~~~14~ TAX YEARS (corporate, individual income, and withholding tax only) 1996 o PARTIAL RELEASE. The State Tax Lien is partially released as follows: UCC Instrument Number Coun~ Instrument Number TAX YEARS (corporate,' individual income, and withholding tax only) . o SUBORDINATION. The State Tax Lien is subordina1ed as follows. UCC Instrument Number County Insuument Number .. I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in determination of the termination, partial release, or subordination indicated above. lID, (.3011 ) Revenue Senior Agent 'f 7/:2065- 385..6073 Title Date Telephone Number Revenue Supervisor /0/7 /() ~ Title Dafe ( 4-232~ Rev. 8"96 Supen<ed,.. 4-232069 Rev. 10-95 sign .. here 9\')