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06/10/2009 ~Eb 14:20 FAX 402 471 4429 UCC SECRETARY OF STATE ~M., Hall <br />~~ <br />Please return to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2"° ST STE 460 <br />GRAND ISLAND NE 68803 <br />I~D04/OD4 <br />Ng sre of Skala Bohn q Gala - UCC Tag <br />. §~ <br />2 0 0 9 0 4 6 4 0 9809599020-9 P$s : i <br />MRRTINEZ LYDYA JEAN <br />Filed: 06/10/2009 10:07 RN <br />~~"'°-~~ State Tax Lien Statement of Termination ar <br />~E Certificate of Partial Release or <br />.rer.,.r.www~.r„ ~a.wr..wv <br />Subordination <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Pursuant tv 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, ar subordinated to the extent indicated <br />below, <br />tbraska Identification Number <br />01-9691111 21-5048281 <br />L(en <br />.Business <br />rvumoer Lien tiled with <br />2200800$$ ~ Register of Deeds County <br />BUSINESS NAME AND LOCATION ADDRESS <br />~....... <br />ial Security Number Spouse's Social Secs <br />XXX-XX-6450 <br />a of Lien Tax Category County . . <br />03/11/2008. 01 & 2.1 Hail <br />TAXPAYER NAME AND MAILING ADDRESS <br />.. .. Name <br />LYDIA JEAN MARTINE.Z <br />• Street or Mailing Address <br />_:. 105 PLETCHER TERRACI" <br />4nY State Zip Cade City State <br />GRAND ISLAND NE <br />Type of Actlon <br />®TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. UCC Instrument Number <br />County Instrument Number <br />TAX YEARS (corporate, individual Income, and withholding tax onlyl .2006 Zip Code <br />68803 <br /> <br />990855234 <br />80 315 <br />PARTIAL RELEASE. The State Tau Lien is partially released as folktws: UCC Instrument Number . <br />County Instrument Number <br />TAX YEARS (corporate, individual incomo, and withholding tax only) <br />SUBORDINATION. The State Tax Lien IS subordinated as follows. UCC Instrument Number <br />County Instrument Number <br />- I here y certify that the Nebraska Department of avenue has complied with the revenue laws of the State of Nebraska in <br />determination of the tenninetion partial release, or subordination indicated above. [3d~ <br />S19n ~ Revenue SeniorA~er7~ lAI3 385=6073 <br />here Preparer's ignature Title ~~ Date Telephone Number <br />Revenue Su ervisor <br />• uthorized g u e Title D e <br />42328 Rev. 8.96 Supaaedes 42'JT~9 Rev. 1 U~95 <br />~~ <br />