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07/24/2000 08:50 FAX 14024714429 NEBRASKA UCC IM 003 /003 <br />-_ _ �--- -- ---� HT N111111111illlllillllllllN <br />9990071262 Pas <br />VAN MFTTR MERAL <br />Filed. 0712112000 03 45 9P1 <br />200006024 <br />tr State Tax Lien Statement of Termination <br />or Certificate of Partial Release or <br />n.ereske Subordination <br />d4pa�rnt <br />of revenue PLEASE DO NOT WRITE IN THIS SPA <br />Pursuant to the revenue laws of the State of Nebraska, notice e Nebraska <br />given that the State Tax Lien which has been duly flied by <br />Department of Revenue against the below -named taxpayer, is terminated, <br />partially released, or subordinated to the extent indicated below. <br />lax category Social Security or Fedorat I.D. Number apuuaa <br />8 2 7 5 6 4 <br />v 3 Identification Number 01 507-04-4175 <br />Uon 8 3 2 Date 01 Uen C01Y"h <br />Lien Soria] Number j Pied VYhh <br />�pgtetaotDMWspo_ntyo,erk 07 -0 6 -2000 <br />0 0 0 7 3 64 TAXPAYER NAME AND MAIL <br />BUSINESS NAME AND LOCATION ADDRESS Narne <br />Street or Other Mailing Address <br />state Zip code <br />CyRAND T _SL&WL NE 68802 <br />TYPE OF ACTION 2 0 0 0 0 5 5 6 5 <br />TAX LIEN. The State Tax Lien is hereby fully �tax ed. INST CC �00'0 8 0 61 7_7_ <br />no <br />gate. Individual Income, and withholdinly) <br />[� PART IAL RELEASE. The State Tax Lien is Partially released as follows. Itv51 n%Jmr:m r <br />TAX YEARS YEARS (corporate, individual Income, and whishoiding tax 01110 <br />❑ SUBORDINATION. The State Tax Lien is subordinated as follows. INSTRUMENT NUMBER <br />Return to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2ND ST STE 460 <br />GRAND ISLAND NE 68803 <br />Name of party making eci -Stand '-pal to 1111,0061 tlfic&9 o1 p llui release or subordination with appropriate filkrg offiest <br />1 hereby certify that nie Nebraska Department of Revenue has complied V th the revenue levee of the State of Nebr)as�ka In the determinafion of theF r1 <br />termination. portal release, or Su dinabon indbated abovo. /o' rJ 3n0 i Q r�fi <br />sign Date ` Te�fKKte No. <br />here Pr or Signatura <br />100— <br />Tice <br />rrzed '' t" ° COUNTY OFFICE - Goldenl'od Copy <br />NEBRASKA DEPARTM OF REVE - Whte and Canary Copies TAXPAYER •pink Copy 4.232-88 Rev. 8.90gvP n,4"4.232 -6e Rev. 10'95 <br />