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<br /> �_V S.`C. 4�' " __ � _''-��ir�'+.�'+. s����;���'���t ��y 1'.T`C� �j�.+.���GQ,��������_n��� yxC_...��o i ''...-_ ..-... �,�. .._....,...._. ..
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<br /> � - S#at� �'ax �ien
<br /> ��R ��.�. S#���r�t�rtt of Termination or
<br /> '�'��` �er�ificat� ��: P�rtial Ret �
<br /> °'���• ease or Sul�ordi�aa�on
<br /> � l�an Senaf Numeor pbCUment Serial Oa:o af L•a�* Sotlal Seeurity Numper or �.�J O�w/�
<br /> ��^rt�G FeQa�all.b.lVUmbor � Vr.� ,
<br /> , tiV v 11-16-Eg 5d5-54-�063 . , "
<br /> MeDrasks�.p.ryumb�r Cuunt�r Lien FIIOO v'1�;�� SDOUSe'S Soclal Securlty
<br /> 5&47�79 Nd�� � Regtsler���Ae�os Numnar
<br /> j� Goun:y CICrk
<br /> 8115{NESS NAME AND LQCAYIpN A��RESS TAXPilYER NAAIlE AlJl.l f.tAili.�l0.�i1DRESS
<br /> 8u;iness Name . • !,tame �
<br /> Jennie 0
<br /> Street Aa�ress � Strcet nr Q[`.�r 4�a11Jng ACdrass,
<br /> ' ' ROU� 1� B�x, 2�a:
<br /> Cttv State 2.Ip CoCa Clty SWte Zla Coae
<br /> Grand Isiand NE 68803
<br /> Pmsuant to the�ecemie laws of the State of Nebraska,notice is hereby given that the Stxte Tax Litn which has been dWy
<br /> filed 6y the Nebra�ca pepaztment of Resenue against the a6ove named taxpayer,is tena:aated;partialty reltased,or subordi-
<br /> n�ted to the extent indicated below. �
<br /> TVPE OF ACTtON .
<br /> Gk TERMiNAT10N OF TAX LIEN. 7he State�:�ti Lien is hercby� rully terminated.
<br /> ❑ PARTIAL RELEASE.The State Tax I,ien is p,uti:�l:y rcleascd as folto�cs.
<br /> N�me ot party:-�a����q req�e,t�rr,-espanz��ie for filing cerhft:z:e nt oartiai reiease wttA apprnprlate fiung of ficer. .
<br /> _. ���J�%�I3f.f►}4l810N. TI;e�r;,te.7'ax Lien is subntdir��ted as fultows.
<br /> � /Y
<br /> �
<br /> I`�mo ot ba(Ly IrWV�ing requust antl rasponslbto for Ii�tnq cortificatc nf subotQlndllOn with,7pp,-.�rlato iping rsf��cor, __';�
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<br /> • • T �`:S G��6bY CO►tUy that tne Nebraska Ucpa►tmqnt o� ROYOOUr h-gi Cornplipd ...th thU revenue Id+.vs ot tne 5tato ot NoUraSka In tho ' --�
<br /> aotermlhation ot tnetam�oatron, artla)IoteBCe nr su6nrd�ndtlsry �. :,.'[q 7.c..•.
<br /> .� �
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<br /> :i ' • �
<br /> `•a�9• i ,.
<br /> � � ;axpayers S�rvic� Specialist ����
<br /> ;��� Pr ro 5 f4 ti:n: � ��tio l7ato • f
<br /> c.r—�� � c "
<br /> . � x. ��-�.�--._� Revenue Agent Supervisar _.s - � -f� -,�
<br /> QuthOfliCC`,-:�.'+'Lt��OF� t Itln --- —
<br /> � �.-�-.... - _ oate
<br /> fOR COUNTV c7FFIC1A1:S US£ �..}"?K.
<br /> , ' ..._ , .�.
<br /> THE'111'1'�=D IIUTICE(S) OF T.AIti I,IEN (OR TERbfINATION) IS (ARE� TC1 FIL F�L1c'� QlILX NITH �
<br /> � �GI�t GM' DF.EaS. ,
<br /> THE DOCUM�f'v� (S) IS (AAC) NOT TO aE FORWARf3�13 TO Z'fiE COIJI3TY CLERK.
<br /> DISTREHUTION OF COPIES:
<br /> WHITi:: TO BE V1l�LDATED BY THE 12EG�5'�ER OF' pI;ED5 1lNA RETURNED TO THE
<br /> � UEPARTMEriT flF RL•VENUE.
<br /> GOI��1.?NROD: TO HE KEP� $Y Tli� F�GISii,I: O� bE�t3S.
<br /> DIfiLIt1G Es TO BE ONCE PER MUt2iI� J1ND 'EF4ERE WILL $E NO PRE-F�AYMENT C�F' ���5.
<br /> THANK YOU FaR YOUR COQPEWfTiOrJ.
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