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\ e�^ � <br /> � � G+ <br /> � � `� .�.—y✓� <br /> �' \�t�`� � � � ,. <br /> � � ��,,� � � � A�M � <br /> ;� ' —f � �/�+ �:�5 <br /> ��' `� '� '� N `� -'� .(- c�'� <br /> �O "� '\'� � 't :� r.�. Cy <br /> �i `.��. --• r�i ti <br /> "" _�: u� <br /> ; � ��i`s� x o c/� <br /> Q ,'� .,.-z � r- <br /> , !;.�� � r-' �. E"� c� <br /> \ , � °I' "' �n'�, p„� cn -J r+- <br /> � �� j, �,�` � ._.:�. � � <br /> � ��\� � cn ..0 � <br /> �, � . � � <br /> �, ..� <br /> � � State Tax Lien Statement of Termination <br /> �Ir� or Certificate of Partial Release or <br /> nebraska <br /> � department Subordination � <br /> of revenue <br /> PLEASE DO 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 terminated, <br /> partially released,or subordinated to the extent indicated below. <br /> Nebraska Identification Number Tax Category Social Security or Federal I.D.Number Spouse's Social Security Number <br /> 6002099 21 47-0731495 <br /> Lie�Serial Number Lien Filed With Date of Lien County <br /> 4/0 3/3 2 7 ��e9ister of Deeds �Counry Cierk 3-21-9 4 HALL <br /> BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br /> Business Name Name <br /> K C CONCESSIONS, INC <br /> Street Address Street or Other Mailing Address <br /> PO BOX 231 <br /> City State Zip Code City State Zip Code <br /> GRAND ISLAND NE 68802 <br /> TYPE OF ACTION <br /> �TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. INSTRUMENT NUMBER 9 4-10 2 4 3£3 <br /> TAX YEARS (corporate, individual income, and withholding tax only) XANY 1 A�'� <br /> ❑PARTIAL RELEASE. The State Tax Lien is purtially released as follows. INSTRUMENT NUMBER <br /> TAX YEARS (corporate, individual income, and withholding tax only) <br /> ❑SUBORDINATION. The State Tax Lien is subordinated as follows. INSTRUMENT NUMBER <br /> Name of party making request and responsible for filing certificate of partial release or subordination with appropriate filing officer. <br /> I hereby certify that the Nebraska Department of Revenue has plied with the revenue laws of the State of Nebraska in the determination of the <br /> termina� n, rtial rel se,or s rdination indicated above. � 1 <br /> sign ; �� , r . -. � " .� ���.�a,Y3��-��v��3 <br /> here epa 's ignature T e ate TelephoneNo <br /> C _ 1 <br /> Q]� �itis.,�c<G.�v ��.a.��r�SG-�� � <br /> oriz ig e Title ate <br /> NEBRASKA DEPARTMENT OF REVENUE-Whfte and Canary Copies TAXPAYER-Pink Copy COUNTY OFFICE-Goldenrod Copy <br /> 4232-68 Rev.&96 Supersedes 4-232-68 Rev.10-95 <br />