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02/11/2010 THU 14:3$ FAX 402 471 4429 UCC SECRETARY OF STATE yyy Hall <br /> <br />Please forward to: <br />Nebraska Department of Revenue <br />4500 Ave I PO Box 1500 <br />Scottsbluff, NE 693b3-1500 2 O 1 0 0 0 9 5 O <br />UCC Instrument Number <br />County Instrument Number <br />PiMkraskyr]ly~r~AAxbm+Nl State Tax Lien Statement of Termination or <br />~E'`E~~E Certificate of Partial Release or <br />ww~vr.r rvrn;kr.~r.grrv <br />Subordination <br />PLEASE l]U NUT WHITE IN TF115 <br />Pursuant to the revenue laws of the State of Nebraska, notice is hereby <br />given that the State Tax t_ien 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 Federal Identification Number Soaal Security Number Spouse's Social Security Number <br />12007439 XXX-XX-9068 <br />Lien Serial Number Lien filed with Date of Lfen Tax Category County <br />42540070 C~IX" Register of Deeds County Clerk 12/16/2004 22 Hall <br />BUSINESS NAME A ND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Name <br /> Dennis Nelson <br />Street Address Street or Mailing Address <br /> 3579 N Hwy 281 <br />City State Zlp Code City State Zip Code <br /> Grand Island NE 68801 <br /> Type of Actlon <br />TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated <br />TAX YEARS (corporate, individual Income, and withholding tax only) <br />X003/003 <br />NC Sac o~ S~al~ Jehn R Gale - IICC SPR <br />9930639668-9 P55: t <br />NELSON DENNI5 <br />Filed: 02/11/2010 11:09 pM <br />pART1AL 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) 20D3 <br />12168 <br />SUBORDINATION. The State Tax Lien is subordinated as follows. UCC Instrument Number <br />County Instrument Number <br />.Partial release on roe located at: i.ot 2, Pulte 2nd Subdivision City of Grand I._,,,_ <br />p p ~Y _ _,._. stand, Hall County NE.,.,,. <br />of she ter~gfation,,partial release, or subordination indicated above. <br />sign <br />here <br /> <br />revenue <br />Revenue Agent 02/09!2010 <br />Title ~ ~ ~_ Date <br />Revenue Su ervisor <br />Title <br />308 632-1200 <br />Telephone Number <br />02/09/2D10 <br />Date <br />4.232$6 Rsv. 8-96 Supersedes 4-232.89 Rav. 1U-95 ~ / <br />V <br />