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., <br /> -- _ � � <br /> � <br /> � State Tax Lien <br /> __ _ _. ��,�„�,�, Statement of `�ermination or <br /> �(�"�:w"' Certificate of PaMial Release or Subordin�tion <br /> � Lten Serlal Numher Ooeument Seriat Date of Lio� Socfjl Security Num�er or <br /> Number Feqerall.P.Numbar 9a w ,�000 <br /> 8/11/ 14003 10-31-8 22 <br /> N�brask�1,p. NumOer County Ll�n Fltetl 1YIth Spouse'f Soclal Securlty <br /> 5254051 Nd�� gI Reqlste�01 D�eaf Numb�r <br /> ❑CountY Clerk <br /> BUSINESS NAME AND LOCATION ADDRE59 TAXPAYER NAME ANO MAILINO ADORESS <br /> Husimfs Name N�me <br /> Efto Riddle <br /> 5tre�t ACtl►eu Stn�t or Oth�r Malling Atltl�atf <br /> City Stata ZiP COde City Stits Zlp Cotls <br /> Shelto NE 688 <br /> Pucawnt to the revenue laws of the State of Nebraska,notix Is hercby given that the State Tax Lien whlch has been duly <br /> tiled by the Nebraaka Depardnent of Revenue againn the above named taxpsye�,is tenninated.partially relaxd,or subordl- <br /> nated to the extent indicated below. <br /> • TYPE OF ACTION � <br /> � TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. <br /> ❑ PARYIAL RELEASE.The State Tax Lien is partially released as follows. <br /> __ ___ _ . <br /> Name ot party making ruquest ana respons�ble tor E;l;ny eertttlwte of partlal relaase wlth approprlate tlling ottleer. . � <br /> ❑ SUBORDlNATION. The State Tax Lien is subordinated as follows. ��� <br /> ; �i . <br /> �_ <br /> _ , . . - #_ _- <br /> �.-�� <br /> .� <br /> __ --- _.,__.___ __.._. .___._._.. . ... . ....-- <br /> _ , _ _. ---...... _.. . <br /> Name of panv matcing request ana resnonsidte+or nim9 eert�tteate o�suboraination wltn appropriate tinng ott:cer. ; ° <br /> 1 h�rebY cerNty that the Nebraska Department ot Revonue has tomplletl wlth the revenue laws ot the State of Nebratk�In the <br /> OEtEIIY110dt1011 Ot th8 t8►YT1111dt10fl,PLttl3t�01Q85e or suboitllnatlon IntllCatOd abOVe. =� <br /> � <br /> Slgfi Revenue Agent �� � � <br /> her� Proparer'sS aturo Title Dat� „� <br /> ,� Revenue Agent Supervisor /—Z—�'O a� <br /> Authoriz�tl Stgnature Tlt�e Date '� <br /> FOR COUNTY OFFICIAL'S USE � <br /> -.: <br /> . .� —= <br /> : " :� <br /> ,: � ', , �::�: <br /> a: ' <br /> r.• • ' <br /> •' : • , <br /> te .. <br /> ,•• • <br /> :C : <br /> � <br /> �� <br /> ti <br /> .� <br /> 'i7 <br /> NEBRASKA DEPARTMENT OF REVENUE—White and Canary Copies TAXPAVER—Pink Copy COUNTY OFFICE—Goldenrod Copv <br /> - - -- - -- _..�....�_.----- — - • -- - - ------- . <br /> 4-232-68 Rov.5•86 <br /> TH� 11'I'7y1C� NOTICE(S) OF T14X LIEN (OR TERI�lINA2IOIJ) IS (ARE) TO BE FIL�.L!°`�ibAi�32;68 Rov. 1•81 r==— <br /> '!� � 0! DBl.U3. <br /> THE DOCI)I�lII�1T (5) IS (ARE) NOT TO HE FORWARDED TO THE COUNTY CLERK. � <br /> DI5TRIBU'I'ION OF COPIES: '�� '` <br /> W�IITE: TO BE VALIDATED BY THE REGISTER OF DEEDS AND RETURNED TO THE ��` <br /> � � � DEPAATMENT OF REVENUE. <br /> GOLDENROD: TO BE KEPT HY THE REGISTER OF DEEDS. � <br /> BYLLING IS Z'O BE ONCE PER MONTH NJD TFiEFtE WILL BE Nb PRE-PAYt4ENT CJF f f'R�• �` <br /> � TIIl1NK YOU FOR YOl7R GOOPBRIITION. � <br /> --�- ---- — -___.T__�_._.� _ -- -- ---_------ �, _ <br /> -. .,..rti <br /> < <br /> 1 <br /> .r%�' � � <br /> _, <br /> tf <br /> ���: <br /> �'� ,• <br /> _.. ,,, <br /> .�, <br /> _ -t: =- <br />