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12/28/2009 MON 14:44 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />200910143 <br />Please forward to: <br />Nebraska Department of Revenue <br />4500 Ave I PQ Box 1500 <br />Scottsbluff, NE b9363-1500 <br />X002/007 <br />NE $~c nT Ste\a Jahn R 6~1• - LCC T09 <br />8909615216-5 Pgs: t <br />PHELPS CHARLES R <br />Filyd: 12/28/2009 11:02 AM <br />~.k.~~~,,,.~,~ State Tax Lien Statement of Termination or <br />~EI'~E~1~'~E Certificate of Partial Release or <br />wrww.nw.r n \nr.~Ar.gwv <br />Subordination <br />PLt:ASE DO <br />Pursuant to the revenue laws of the Stake of Nebrasaka, 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 Ident~ication Number Federal Identltication Number Social Security Number Spouse's Socal Security Number <br />14851083 XXX-XX-0894 <br />Lien Serial Number Lien fled with Date of Lien Tax Category County <br />83400157 G]X Register of heeds ]County Clerk 04/10/2009 22 f-fa11 <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Nama Name <br /> Charles R Phelps <br />Street Address Street or Mailing Address <br /> 1615 N Taylor Avenue <br />City State Zip Code City State Zlp Code <br /> Grand Island NE 68803 <br /> Type of Action <br />[X TERMINATION OF TAX LIEN. The State Tax lien is hereby fully terminated. UCC Instrument Number 98095929856 <br />• County Instrument Numbsr 200902692 <br />TAX YEARS (corporate, individual income, and withholding tax only) 2DQ7 <br />PARTIAL RELEASE. The State Tax Lien is partially released as•follows: UCC Instrument Number <br />County Instrument Number <br />TAX YEARS (corporate, Individual income, and withholding tax only) <br />SUBORDINATION. The State Tax lien is subordinated as follows. UCG Instrument Number <br />County Instrument Number <br />I etebv certify that thQ Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska m <br />date i ation o the to ihation, partial release, or subordination indicated above. <br />sign Revenue A enter 12/23/2009 308 632-1200 <br />here a Title ~ Data Telephone Number <br />Revenue Su ep fVl50r ~ 12/23/2009 <br />Authorized Sig re Title Data <br />42328 Rev. 898 Supersedes 4-2328 Rev. 7D-95 <br />