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10/06/2009 TUF 14:33 FAX 402 471 4429 UCC SBCRETA1tY OP STATE -+-~y Hall <br />X002/005 <br />NB see p1 s!~!p Jphn A Otle - YtC Te! <br />D~ <br />Please forward to: ssesseaa~t-a Pge; , <br />MUELLER LE'VI R <br />Nebraska. Department of Revenue 2 O o 9 ~ g ~ s 4 Fl led; 10/0fi/2009 08:48 AM <br />4500 Ave I PO Box 1500 <br />Scottsbluff, NE 69363-1500 <br />t~wa~sre.n.~N...e~or State Tax Lien Statement of Termination or <br />~''E~'~E Certificate of Partial Release or <br />VNW W.IAFV r6Y111. f.w.Y.~-V <br />~ ^ Subordination <br />!PLEASE DO NOT WRITE IN THIS <br />Pursuant to tha reven.ule laws of the. Stpto of Nebraska, notice is hereby <br />given that the State Taz Lien whibh 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 Federal Identification Number Social Security Numbar Spouse's Social Security Number <br />42883680 XXX-XX-0924 <br />Lien Serial Number Lien filed with Date of Lien Tax Category County <br />82630250 ©Register of Deeds ~Gounty Clerk 08/10/2009 22 Hall <br />BUSINESS.NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADt]RESS <br />Business Name Name <br /> Levi A Mueller <br />Street Address Street or Mailing Address <br /> 4117 Mason Ave <br />City State Zip Code City State Zip Gade <br /> Grand Island NE 68803 <br /> Type of Actlon <br />® TERMINATION OF TAX LIEN. The State Tax Llen is hereby fully term(natad. <br /> <br />TAX YEARS (corporate, individual income, and withholding tax only) 2007 UCC Instrument Number 99096045106 <br />County Instrument Number 200906709 <br />PARTIAL RELEASE. The State Tax Lien is partially released as foAows: <br /> <br />TAX YEARS (corporate, individual Income, and withholdtng tax only) UCG Instrument Number <br />County Instrument Number <br />SUBORDINATION. The State Tax Lien is subordinated as follows. UCC Instrument Number <br />County Instrument Numbar <br /> <br /> <br /> <br /> <br />S19r1 <br />here <br />y uia urn wlsuiasna vepartmenL pT Kevenue nos wmp118a WI[n Lne reVenUe <br />the .i ~ lion, partial release, or subordination indicated above. <br />Signature <br />Revenue Agent 10/01/2009 <br />Title ~'~ pats <br />Revenue Su ervisor <br />Title <br />308 632-1200 <br />Telephone Number <br />10/01!2009 <br />Date <br />4~32~8 Rev. 8-96 Supersedes 4-2329 Rev. 10-95 <br /> <br />