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r6 <br />I <br />. <br />State Tax Lion <br />ftnt6ta�.%. Statement of Termination or <br />1110mip-f"", <br />contucate <br />oT Partial <br />heNaaa or suuorampon <br />Lien Sarial Number <br />oncum.nt settal <br />Date of Lien <br />Soc4f Security Number or <br />Number <br />Federal I.D. Number <br />2102 854 <br />12734 <br />2 -22 -89 <br />507 - 70-0544 <br />gg. 103591 <br />Nepraaka I.D. NlrM er <br />County <br />n Filed With <br />Spouse's Social Security <br />4621 492 <br />Fa l l <br />"e111,1111e of aetw <br />Q CaYflty Clerk <br />Number <br />*MINIM NAME AND LOCATION <br />AODRElIIi <br />TAXFAVBR NAME AND MAILING ADOREIW <br />autimm Name <br />Name <br />Michael J. Woodard <br />Street AddfeN <br />Street or Other Mailing At dfm <br />3562 West Old ft. 30 <br />City <br />State <br />Zip Code <br />City State Zip Cow <br />Grand Island, NE 68801 <br />Pit oomt to the cereatle laws of the State of Nei raska. settee is hereby Siren that the State Tax Lim &at titles r <br />f 4' by the Nokx*a Departreat of Ret+et111e arftet the above. ariadoeit. taxpayer. ie tetrnt;eatei, pgutttiafll4y t iel>rtil�ed, or strlhwc l- <br />mood. to the exteat indicted bdowr. <br />Q TERMINATION OF TAX LIEN. The State Tar Lien is hereby fu.Uy termilt <br />❑ PARTIAL RELEASE. The State Tax Lien is Partially released as follows. <br />Name of early making reduixt and relpnn TJ hio for fit Ing CeI IIIlCate of paftiai. ideate Wit" appropriate filing officer. <br />SUIfW60O ATION. The State Tax Lim is subordinated as folln' .J. <br />t <br />- <br />e =- <br />1 hereby C %nary Vial the Nebraska 000artm•nt of Revenue has compiled with the revenue law% of the State of NtCtA*a in thM <br />Ci1.!oN: fl lnation of the termination. partial release or subordination Indicated about. - - <br />Taxpayers Service Specialist <br />Y1e Titre <br />..:,..� Revenue Agent Supervisor <br />Srgnature T rt l• <br />FOR COUNTV OFFICIAL: S USE <br />Date <br />Oate <br />NEMIASKA OE►ARTMENIT OF REVENUE - White and Canary Copies TAXPAYER - Pink Copy COUNTY OFFICE - Goldenrod Copy <br />1'!7 1110RICi(s? ar nz um (On IS (ARF) In Be FILED M!T!I <br />�. <br />THE DOCUKOT'(S) 18 (ANS) NOT TO BE FORWARDED TO THE COMITY CLERK. <br />DISTRIf1U'CI00 OF CDPIESt <br />WHITES 70 BE VALIDATED BY THE REGISTER OF DEEDS AND RLMRNED TO THE - <br />DEPAAT"M OF REVENUE. <br />GOLDZNPWt TO BL KEPT BY THE REGISTER OF DBEDS. <br />BILLING IS TO BE ONCE PER llC*= AND THERE WILL BE NO PRE- PAYME2iT OF FEES. <br />THARr< YOU FOR YOUR COOPERAT'IMI. <br />