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07%11,120,01 15:48 FAX 14024714429 NEBRASKA DCC R002/002 <br />Or <br />eepsrtmerrt <br />200106823 <br />State Tax Lien Statement of Termination <br />or Certificate of Partial Release or, <br />Subordination <br />TYPE OF ACTION <br />tTERMIIN�Aln�Ot OF TAX LIEN. The State Tax Lion is hereby fully terminated. IINNSTRUMENT NU EI —q.9 orporate, Individual Income, and withholding tax only) "l4 4 q5 <br />0 PARTIAL RELEASE. The State Tax Lion is partially released as follows. INSTRUMENT NUMBER <br />TAX YEARS (corporate, individual Income, and withholding tax only) <br />❑ SUBORDINATION. The State Tax Lien Is subordinated as follows. INSTRUMENT NUMBER <br />_ Plans retumto: <br />STATE OF NEBRASKA <br />- <br />DEPARTMENT OF REVENUE <br />1811 WEST 2ND ST STE 460 <br />- GRAND ISLAND NE 68803 <br />Name of party making request and responsible for filing certificate of partial release or subordination with appropriate filing officer. <br />I hereby ' that the Nebraska Deparinlent of Revenue has oomplied with the revenue laws of the Slate of Nebraska In the determination of the - <br />terminalion rh erase r subordin.etlon indicated abo ve. <br />sign /1�,�„,, - t�6s),3ss -r�z,z <br />here Pr 'a6igneture Tile to -Telephone No <br />A prized n to a Tito <br />NEBRASKA <br />f\A <br />OF <br />White and Canary Copies TAXPAYER - Pink Copy COUNTY OFFICE - Goldenrocl Gopy <br />4-232­e8 Rev. aAe Supwaadoa 4.27288 P -.1045 <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Pursuant to the revenue laws of the Stslte of Nebraska, notice is hereby <br />given that the State Tax Lien which has been duly filed by the Nebraska <br />DepartmentofRevenue againstthe below -named taxpayer, is terminated, <br />partially released, or subordinated to the extent indicated below. <br />Nebraske IdenhficationNurnber <br />Tax Cat%Gory <br />Social Security or Federal I.D. Number <br />Spouse's Social Security Number <br />39475468 <br />594 -39 -5880 <br />Uen Serial Number <br />_22 <br />Uen Fled With <br />Date of Lien <br />County <br />991760170 <br />E] Register of Deeds ❑ County Clerk <br />8_15-99 <br />- : HALL <br />NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILiNO ADDRESS <br />_BUSINESS <br />Business Name <br />Name <br />LEONZO POL LARES <br />Street Address <br />Street or Other Mailing Address <br />504 S ADAMS <br />�. r <br />Cris State ZpCode <br />Cty State Zip Code <br />GRAND ISLAND NE 68801 <br />TYPE OF ACTION <br />tTERMIIN�Aln�Ot OF TAX LIEN. The State Tax Lion is hereby fully terminated. IINNSTRUMENT NU EI —q.9 orporate, Individual Income, and withholding tax only) "l4 4 q5 <br />0 PARTIAL RELEASE. The State Tax Lion is partially released as follows. INSTRUMENT NUMBER <br />TAX YEARS (corporate, individual Income, and withholding tax only) <br />❑ SUBORDINATION. The State Tax Lien Is subordinated as follows. INSTRUMENT NUMBER <br />_ Plans retumto: <br />STATE OF NEBRASKA <br />- <br />DEPARTMENT OF REVENUE <br />1811 WEST 2ND ST STE 460 <br />- GRAND ISLAND NE 68803 <br />Name of party making request and responsible for filing certificate of partial release or subordination with appropriate filing officer. <br />I hereby ' that the Nebraska Deparinlent of Revenue has oomplied with the revenue laws of the Slate of Nebraska In the determination of the - <br />terminalion rh erase r subordin.etlon indicated abo ve. <br />sign /1�,�„,, - t�6s),3ss -r�z,z <br />here Pr 'a6igneture Tile to -Telephone No <br />A prized n to a Tito <br />NEBRASKA <br />f\A <br />OF <br />White and Canary Copies TAXPAYER - Pink Copy COUNTY OFFICE - Goldenrocl Gopy <br />4-232­e8 Rev. aAe Supwaadoa 4.27288 P -.1045 <br />