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r <br />�x <br />` 4 <br />1 <br />State Tax Lien <br />Statement of Termination or <br />VW1;F &ifiW certificate <br />of mitts <br />Rejease or subordination <br />Lien Serial Number <br />nocumert Serial <br />Oate of Lion <br />Social Securlty Number or <br />r <br />89-- 101200 <br />3/03/193 <br />12402 <br />3 =2 -83 <br />505-5D-9386 <br />NebraSika I.D. Number <br />County <br />,rLien Filed t•'ylth <br />Register of Deeds <br />Spouse's Social security <br />Number <br />2751380 <br />Hall <br />re l <br />County Clark <br />BUSINESS NAME ANO LOCATMN <br />ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />Name <br />Safari Bar � Lounge <br />Street Address <br />Stcoet ur Otrler Mailing Address <br />106 East 3rd Street <br />Shady Bend Road <br />City State <br />ZIP Code <br />City State Zip C4ov. ." <br />Grand Island, NE <br />68801 <br />1 Grand Island, NE 688M., ; <br />Pursuant to the revenue laws of the State of Nebraska, notice is hereby given that the State Tax Lien which has been"*'.. <br />filed by the Nebraska Department of Revenue against the above named taxpayer, is terminated, parWfly released, or subor&: <br />hated to the extent indicated below. <br />TVVC OF ACTION <br />lr3l TERMINATION OF TAX LIEN. The State Tar Lien is hereby fully terminated. <br />C..tPP40TIAL RELEASE. The State Tax lien is partially- released as follows. <br />Name of party making request and respons,ble + % :•t Oil Inq certificate c f 19+eJSe with appropriate filing officer. .. <br />i <br />Cl SUBORDINATION. The State Tax Lien is stitordmated as Inflows. <br />Name of party making request and rdsponsShle,filr ;itrrg rr illlrate of suooroination with appropriate filing officer. <br />I hereby Certify that the flFurafka Department of Rct +irhs9 has Compiled -with the revenue laws of the State c f r.;�Y:AT,Ska jr, the <br />dets:minatron af.fhe.termination; partial release nr subordin;,f.�rr. ,nolwted anbvu. <br />sign - t& Taxpayers Servjce Specialist <br />here 's. <br />q ,turn Title Cate <br />t' Revenue Agent Supervisor <br />� <br />AuthorlZdd 51911eture Title pate • <br />FOR COU tTV OFFICIAL'S USE <br />NEBRASKA DEPARTMENT OF REVENUE - White and Canary Cc�: -1s TAXPAYER •- Pink Copy COUNTY OFFICE - Goldenrod Copy <br />4.232 -68 Rev. 5.86 <br />Supersedes 4.232.68 Rev. 1.81 <br />J <br />rip, <br />rf+ <br />