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04/25/2011 MON 15:23 FAx 402 471 4429 UCC SECRETARY OF STATE -�-�y Hall <br />;' <br />� <br />2 ��J.103�.70 <br />�„� State Tax Lien Statement of Termination or <br />,�. Certificate of Partial Release or <br />. Subordination <br />u� <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 flled by the Nebraska <br />Department of Reve�rue aga�qst�the•below-�raa�ed taac�payer� �is� � <br />terminatetl, partlally released� or subordinated to the extent indicated <br />below. � <br />Lien <br />19478550 <br />62230085 I QRegister of Deads �Counry <br />'BUSINESS NAME AND LOCATION ADDRES9 <br />subordination indicated ebove. <br />Ross, Robin L. <br />treet or MaUing Addres: <br />904 W 10th Street <br />�'ry 5tate Zip Code Cit�► State <br />Grand Island NE <br />Type of Actlon <br />QX TER�AINATION OF TAX UEN. The Stete Tax Lien is hereby fulfy terminated. UCC Instrume�rt Number <br />County Instrument Number <br />68801 <br />2007�3343 <br />TAX YEARS (corporate� Individu�al Income, and withholding ta�c only) 2004 ' <br />[� PARTIAL RELEASE. The State Tax Lten Is partially released as follows: �CC Instrument Number <br />County Instrument Number. � <br />TAX YEARS (corporate� individuai income� and wlthholding tax onty) � � • <br />� 9UBOROINATION. The State Tax Lien L� subordinated as follows. UCC Instrument Number <br />County Instrument Numb�r <br />the <br />sign <br />here <br />Hall <br />TAXPAYER NAME AND AAAILING ADDRE53 <br />revenue <br />�Revenue Agent 04/22/2011 308 632-1206 <br />T'�le Date Teiephone Number <br />Revenue Supervisor . 04/2212011 <br />T1de Date <br />4232� Rev. 8,98 Supersedes 4 232-89 Rav.10,95 <br />XXX XX-9922 <br />Date of Lien Tax Categ <br />aaiz��zoo� �a <br />�002/002 <br />