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State Tax Lien <br />r Rrae►a Statement of Termination or <br />"WI rto * _C_ertificate of Partisan Release or Subordination <br />L en Set lat Number lri CrJntunt hvrt.fl date alt Lien Social 5etut 1 tt, Nu-teer ur <br />Numnot Fs*f".1t f U, NtlmDer <br />85172038 12727 322 -69 505 -38 -6794 t--. <br />740141-14 1 p28' i <br />brasrra I.Q. Number <br />linty Cmt'r Lien F liar! With 5uouse's Social socunty <br />29470099 Hall its County of De.da N�V 44 -5861 <br />[,J County Clerk <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Narne <br />Charles & Lena Mettenbrink (decd) <br />Street Address Charles <br />or Other Mailing Address <br />Box 759 <br />Clty State 21p Coco City <br />State 21p Code <br />C-. Island, NE 68802 <br />Pursuant to the revenue laws of the State of Nebraska. notice is hereby given that the State Tax Lien which has been duty <br />filed by the Nebraska Department of Revenue against the above named taxpayer, is terminated, partially released. or subotdi. <br />nated to the extent indicated below, <br />TYPE OF ACTION, <br />X TEANIINATiON OF TAX LIEN. The State Tar Lich is hereby fully tennin ttt;tl. <br />PARTIAL RELEASE. The State Tai Lien is parttally released as t«pt�ivg. <br />Nz;t of party making request anti micro ++taste ±+sr "illnq FOrUt�� ate n+ uart:Suaat+ese with appropriate tiling offlCer. <br />r'4013ORDINATION. The State Tax Urrils subtr1'dulaNd as folhms. <br />Name or pane making request a- tirtrsponsibie to filing cor*,f1f;Z•'W yr sunetd•r•,a;ion with appropriate filing om <br />1 hereby certify that the Ne ;:'416+e fit Revenue has Cornp11013 with the revenue laws of the SSAte of Nebraska In the <br />determination of the termination. partial release• qr ,uuordloat Ion ind,catoo above. , <br />sign Revenue Agent Supervisor <br />hers%.$ <br />7Wor ! ature Tits© <br />Late <br />Revenue .Agent Supervisor . <br />Authorized S19nnt urrr 71Ue <br />oate <br />FOR COUNTY OFFICIAL'$ USE <br />NEBRASKA DEPARTMENT OF REVENUE White and Canary Copies TAXPAYER Copy <br />COUNTY OFFICE'— voldenrod Copy <br />4.232.68 Rev. 5.86 <br />:.51-17, (odes 4 232.68 Rev. 1 -81 <br />v'J <br />4- <br />