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04/02/2010 FRT 15:11 FAX 402 471 9429 UCC SECRETARY pF STATE yy-~ Hdll <br /> <br />Please return to: cti O 1 ('S O 2 i 7 ~ <br />STATE OF NEBRASKA ~r 1 v <br />DEPARTMENT OF REVENUE <br />1811 WEST 2"1' ST STE 460 <br />GRAND ISLAND NE 68803 <br />t~+b••[i+kAi ~~arremar+tal <br />~E~1''E1~~, <br />rirww.rwww nirr.ma.porr <br />1002/003 <br />NE Stra of Sla~^ Johr, p 6~I• UCC 709 <br />9910823716-8 Pss: t <br />LEMBURG WRRREN <br />Filed; 04/02/2010 08:57 Arl <br />State Tax Lien Statement of Termination or <br />Certificate of Partial Release or <br />Subordination <br />NOT WRITE IN THIS SPACE <br />Pursuant to 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, or subordinated to the extent indicated <br />below. <br />Nebraska Identification Number Federal Identification Number Social Security Number Spouse's Social Security Number <br />9809171 20-4841372 XXX-XX-7442 <br />Lien Serial Number Lien filed with Date of lien Tax Category County <br />03/07/0041 Qx Register of Deeds County Clerk 08/24/2007 01 Hall <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Name <br /> Warren Lemburg <br />Street Address Street or Mailing Address <br /> 5137 N 190th Road <br />City State Zip Code Ciry State lip Code <br /> Cairo NE 68824 <br /> Type of Action <br />Qx TERAAINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated <br />TAX YEARS (corporals, individual income, and withholding tax only) <br />UCG Instrument Number 9907523117-0 <br />County Instrument Number 200707361 <br />PARTIAL RELEASE. The State Tax Lien is partially released as follows; UCC instrument Number <br />County Ir~trument Number <br />TAX YEARS (corporate, individual Income, and withholding tax only) <br />[~ SUBORDINATION. The State Tax Lian is subordinated as follows. UCC Instrument Number <br />County Instrument Number <br />I hereby certify that the Nebraska epartment of Revenue has complied with the revenue laws of the State of Nebraska in <br />determi ation of the termin lion, partial release, or subordination indicated above. ~ 308] <br />51911 Revenue Senior Agel1~ 331 ~ ~ p 385-6073 <br />here Frepar r' Signature Title Date Telephone Number <br />_Revenue Senior Agent _ ~~ 31 l~Q, ~ p <br />Aut rite 5ignalure Title ~~ Date <br />4-2328 Rev. 8-96 Supersedes 4-2329 Rev. 1 D-95 <br />