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...,,,., <br /> � <br /> � _,::.�,. <br /> ,. R <br /> 2. ., , `�`-ec____'."` <br /> " h� r� . ' <br /> , . . :'Xr�. . . ' .. . ' <br /> ,. . F` <br /> ' - -' . . . .. . . ..� r . � . . . �� e . JJ_-_=__.__ <br /> � .. . . '- . . - __—' <br /> , . ' ��' � <br /> A�-\\ `� Iw <br /> ' �' .� � W � � <br /> : -v o �-+ n� <br /> � � � � <br /> � -a � <br /> : �� �` , � ' ! (�` n � � m � � <br /> � � -e o <br /> , .,....e.�+'� � �`y�\ . . :! � F-�' r.� -n <br /> n��� \ � � 7 v � s m I� 1rr <br /> . �j . «. <br /> ' �� I n � T- m i-' � <br /> r �0 `� � r-. y p <br /> � *'7 �� � \ � � y � <br /> • � .ji `� <br />- C7 "" rr <br /> ' .i' ' N <br /> ~ cn "� � <br /> � � State Tax Lien Statement of Termination ? <br /> � or Cert(ficate of Partial Release or <br /> � a�«� __ Subordination '� <br /> , PLEA8E 00 NOT WRITE IN THIB SPACE � <br /> ' Punu�nt to the revenue IawA of the State nl Nebr�ska�nntice Ir herrby <br /> � klvcn tbwt the State'fpx L.len which hd9 fxen duly tllcd by the Ncbrux{w <br /> prprrlment nf Revenue wRr�lnht thehelow.nrmed t�xp�ycr�lq terminatcd, <br /> purtially releA�rd�nr tiuhnrdineted tu the extent Indic�ted t►eluw. <br /> Nebraska Idennficat�an Nmnber TexCategory Soaal Socunty a FeGeral I.D.Number Spouse's Sodal Security Number – <br />- - - – ��?t::�2 JI ��1�–�8–Q j'i� r. <br /> �en Serial Nwnber UenFdeC With Dateot Lien Counry = <br /> 7 0% �9 3 [��e9�s�er o�Deeda O County C�er►c 7_21•.9 7 I3 ALL :_ <br /> BUSINESS NAME AND LOCATION ADORESS TAXPAYHR NAME AND MAILINd ADDiiES3 —� 4. <br /> Busines�Name Name 4' <br /> UEiVNIS i.IMBI;GN,AN i'- <br /> .- <br /> Street AEdreae Street or Other Mailing Adtlress <br /> �25U NORZ'H W�fit� 12ll �' <br /> E`_ <br /> Gy State Zp Code Ciry State Lp Coae _ <br /> GRi�,ND ISLAivD NE 6fiB03 � <br /> �. <br /> � TYPE OF ACTIQN � <br /> �TERMINATION OF TAX LIEN. 'ltic 5tntc Tax Licn (s hercby fully tctminatcd. INSTRUMENT NUMBER 9 i-1 U15959 i;-- <br /> TAX YEARS (cor orate, Indivlduel fncome,end withholding tax only) !` <br /> P e;� <br /> ❑PARTIAL RELEASE. The State T�x Licn is partially rcicascd a�follows. INSTRUMENT NUMBER <br /> TAX YEARS(corporate, individuei Income,and withhotding tax only) �`=`° <br /> �.-= <br /> �T�. <br /> ❑SUBORDINATION. '[l�e Statc Tax Lien is subordinated as follows.INSTHUMENT NUMBER <br /> . � �•._•:. <br /> Name of party muking rOquBSt and rn5ponsible fahling cerLhCato ot par6al release or eubOrtlmat�on with qppropnate fihnp ofhcer. <br /> I horoby certdy that tno No�iaska Dcrpanmctnt of Rovonue • comphW with the revnnue laws olthe Stato of Nohrasku m tha determtna[ion of L1e <br /> twminauon,panlairo ase.orsubordinadonmdicutodnbove. <br /> S�9n�°� ��e� p�, � / ��,.�8��o� <br /> here reparer'sSignatu dIO Dato TelephoneNO. <br /> + g� ..� `S.'r��-�_�5''�� Date <br /> � AuthonYOtl g t0 TiUe / <br /> � NEBRASKA DEPARTMENT OF REVENUE•Whi1e end Canary Copl�s TAXPAYER-Pink Copy COUNN UFFICE•Cioldenrod Copy <br />- ' �232•68RSV&995upMtM�t4�232�6ERw 10-99 �� -��� <br /> 1 <br /> ' <br /> �l_.. . _. ._.__._ . <br />