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<br /> � � State Tax Lien Statement of Terminatton ���`��
<br /> ��� �� or Certificate of Partial Release or � ���--
<br /> � ,,.�,.�. _
<br /> ° �� �� Subordination �' . �-----
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<br /> � PLEASE DO NOT WRITE IN THIS SPACE � �"__
<br /> • Pursuent to the revenue lews of the State o[Nebraska,notice ts hereby
<br /> ,,�� given that the State Tax Llen which has bee�duly flled by the Nebraske �__
<br /> DepyrtmentoPRevenue against the below-aa�r.ed tnxpayer,Is terminated, �y
<br /> partlally released,or sutwrdlnated to the extent indiceted below. _
<br /> :
<br /> ,
<br /> Nebreske ld6ntificetlon Number Tax Category Soclal Securiry or Federal I.D.Number Spouse's Social SecunryNumber
<br />-- -
<br /> ---- - - uen Se�iai ivumoer iaun r`iicti W�in vain ui Gr.� 'uuty
<br /> 7/0 6 �66 �Register af Deeda �County Clerk �_18-9 7 IiALL `
<br /> k3USINESS NAME ANO LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS
<br /> � Business Name Name
<br /> PR[:MIFR I1VC -
<br /> � StreetAAdresa Stroetorpther MailingAdtlress
<br /> 40!iS lOLA LA TB
<br /> Ciry Stete Lp Code City State Lp Code
<br /> � GRAiVD ISLAI�A N� 6�i8U:3
<br /> TYPE OF ACT10N �
<br /> �JTERMINATION OF TAX LIEN. Thc Statc Tax Licn is hcrcby(ully tcrminatcd,INSTRUMENT NUMBER 97_104 93 2
<br />_ � TAX YEAtiS (corporsts,Indlviduel Income,and w(thholding tax only) ]9c 6
<br />' ❑PARTIAL RELEASE. The Satc Tax Lir,n is paTtiatly rcteased os follows.INSTRUMENT NUMBER
<br /> - ' TAX YEARS (corporats,indlvidusl Income,and wlthholding tax only) r�
<br />'." � ❑SUBORDINATION. The Statc Tax Licn is subordinatcd as follows.INSTRUMENT NUMBER
<br /> .� �
<br /> ',;i:�
<br /> � �.' .�
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<br /> Namo 01 party making request end rosppnsible tor filing cenificate of pani�l releasa or subordmaUon with epproprlate filing oihcor. `'��`-
<br /> '� � -
<br /> � I horeby ccNUly that the Nt3braska Department of Revenue has campded wdh the rev�nue IawB of the Stat�of Nebraska In ihe d�torm�naoon of the . --
<br /> ter�una�rtfal rele sa.o�bordination intlicatotl ubove.
<br /> 1 sign , p�,�(� �h. � ' ��i� 9 �.�s`-��
<br /> � her�e r��ar sSignature [ Title Date TelephoneNO.
<br /> I Q�� AWariz g e r � T�tl- e ��` / ��� at
<br /> I _
<br /> � NEdRAS DEPARTME T OF REVENUE•Whfte and Canaiy Coples TAXPAYER•Pink Copy COUNTY OFFICE•Gddenrod Copy
<br /> 4232�68 Rev.698 S�pKtscte��.232-69 H�v.tP95
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