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rr _ .. __ _.__. . _ ._ � _. . _ __ <br />;=sa� <br /> , - -' -'• ' � � <br /> CJtM�Pv T:�� ��vQ� <br /> ,�. Statemen# oi Terminetlon or <br /> `"""` Cbrtiiicate o! Partial Relaass or Subor�nation <br /> � nwmw <br /> L��n S�rla1 IVumwr pocum�nt S�Na� Dat�af L�en Socl�l S�curity Number or <br /> NumWr F�tl�n11.0.NumWr <br /> � 09 633 14Q92 9-1-89 505-70-9658 g��'�o�i��,0 <br /> Atebr�sk�1.0.NumW► Gounty Ll�n Fll�tl With Spous�'�Soclal S�curity <br /> � Rt41st�►ot DNOf Numbar <br /> 4920023 Hd�� ❑ Countfr Clnk <br /> ! YUiINE�B NAME AND L�CATION ADDRESS TAXPAYER NAME AND MAILINO ADDRESS <br /> �uslrt�a Nam� Nam� <br /> StrNt AtJdn3f St►Nt or Oth�r Matlln9 Addnss <br /> Ctty Stite 2ID Calo Clty State 21p Coae <br /> NE 685 2 <br /> Punwnt to the cevenue laws of the State of Nebrasks.notice Is hercby given that the State Tax Lkn which hsa been duJy <br /> , � filed by the Nebrnaka Department of Revenue apinat the above named taxpaye�,i�terminated,partially nlaxd,or subordi- <br /> ( n�ted to tMe extent indicated betow. <br /> � TYi'E OF ACTIUN <br /> , �1 TERMINATION OF TAX LIEN.The State Tax Lien is hereby fully terminated. <br /> ! � PARTIAL RELEASE. The State Tax Lien is partially rzleased as follows. <br /> Nams ot party making request an0�esponsible tor f�linq eertitleate ot partlal re�ease witn approprlate tlling ofllcer. , <br /> ' � SUBOiiOINATION.The State Tax Lien is subordinated as follows. � <br /> —.� -. - ;.�_ <br /> ��..,�. <br /> .- �_.�,: <br /> . .��,;y - <br /> � Nams of pa�ty makin9 reQusst and rosPOnsibte for iiiing certlilcate o�subortltnatlon wlth apvroprlate filing officer. <br /> � ''I h�nby certNy that the Nebr�ska Departmeni a! Revenue has eomplletl with the revenue laws ot the Sate of PiAbraSka In the <br /> . tlet��mination of the termination,parllal reiease or subortlinatlon intllcated above. <br /> r <br /> � ` _ <br /> , • S1g11 Taxpayers Service Specialist ��` Q <br /> ;�he e rer Ignatur Tltle Uats <br /> Revenue Agent Superv9sor �a6 _��o <br /> Au4hotii�C Slynatu TIt1O Q�t� <br /> .. _.____.,, _ FOR COUNTY t1FFiC1AL'S USE _ <br /> ' '!'�iE llTT79CHLD NOTICE(S) OF TAX LIEai (OR'TBRMINATION IS � I•�� <br /> ,. !!Q �,I/!!R O! DESDS. � t�) TO BE FILID OliLY MI!!! <br /> . � � . <br /> TNS DOC[JMENT(S) ZS (ARE) NOT TO BE FORWAR�ED TO THE COUNTY CLERK. <br /> DISTRIBUTION OF COPIES: <br /> WHITEs TO BE VALIDATED AY THE REGISTER OF DL�EBS AI3D RETURi3ED TO THE <br /> _ DEPARTMENT OF REVENUE� <br /> � GOLDENROD: T� gE KEPT BY THE REGISTEH OF�llEEDS. <br /> BILLING IS TO BE ONCE PER MONTH ANb THERE WILL BE NO PRE-PAYMENT OF FEES. <br /> THANK YOU FOR YOUR COOPERATION. <br /> NEBF�ASKA DEPAR7MENT OF REVENUE—White and Canary Copies TAXPAYER—Pink CopY COUNTY OFFICE—Goldenrod Copv <br /> 4•232-68 Rev. 5•86 � <br /> 5upersetles 4•232•68 Rev. 1•81 <br /> i <br /> � • � � ,. <br /> , � <br /> �� <br /> � <br /> �N <br /> ' �� <br /> r <br /> � � <br />