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r <br />1 <br />State Tex Lien <br />Statement of Termination or <br />90-105536 <br />+•�« <br />c <br />ITI <br />Ste 01 Partial <br />Release Subordination <br />or <br />Lion Serial Number <br />Document 1501191 <br />Date of Lean <br />50c1a1 5ecurit r Number or <br />��- <br />8/12/586 <br />umber <br />4720 <br />11 -28 -88 <br />Federal I.D. Number <br />Nebraska I.D. Number <br />County <br />his FHad With <br />spouse's SaciolSecurity <br />5055571 <br />Hal l <br />Register of Deeds <br />Number <br />Count: Clerk <br />BUSINESS <br />NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Nome <br />Name <br />The Floret Flower Shop, Inc <br />Street Address <br />Street or Other Mailing Address <br />South Locust <br />City <br />Sgt* <br />ZIP Code <br />City State 21p Code <br />Grand Island NE 68801 <br />runumt to the nvenue hws of the State of Nebraska. notice is hereby given that the State Tax Lin w" has been duly <br />OW by the Nebraska Department of Revenue assiast the above named taxpayer. is terminated, partially sxkaaed. at udmr& <br />maNd to lire extant itndiellted below. <br />l TYPE OF ACTION <br />TERMINATION OF TAX LIEN. The State Tax Lien is hereby fuUy temninated. <br />Tnctriminnt Nwh er ag - 1 Ar3612 <br />❑ PARTIAL RELEASE. The State Tax Lien is panially released as follows. <br />a <br />Name of party making request and responsible for flliny certificate of partial release with aparmo'ata tiling officer. <br />❑ SUBORDINATION. The State TAX Lien is suhordlnated as iollows. <br />I� <br />I - <br />Name of parry making request and responsible for filing certificate of subordination with appropriate filing officer. <br />" I hereby certify that the 149brasks Department of Revenue has complbod with the revenue laws of the State of Nebraska Ir, the <br />I' <br />d0l" tln9tlon as the termination, partlal release or subordination Indicated above. <br />"4.06-2.) Taxpayers Service Specialist <br />arepre Sq ure T rM, Date <br />�� .- Revenue Agent Supervisor <br />utnalse0 SMnatun T1tle Date <br />FOR COUNTY OFFICIAL' S USE <br />THE ATTACHED WTICE(S) OF TAX LIEN (Olt TWHIMVION) IS (ARE) TO BE FILED ONU VIM <br />i7i MNMBM 011' =DS. ilir <br />THE DOCUMENTS) IS (ARE) NOT TO BE FORWARDED To ''4IE COUNTY CLERIC.. <br />DISTRI.EUTION OF COPIES: <br />WHITE: Tr IaE VALIDATED BY THE REGISTER OF E*J. :,JS AND RETURNED TO THE <br />DEFARTMENT OF REVENUE. <br />GOLDEW'1?1?01 : TO BE KEPT BY THE REGISTER 0= DEEDS. <br />BILLING IS TO BE ONCE PER MONTII AND THERE Wti.T. SF NU FRF.- I'AWIFTST OF <br />THANK YOU FOR YOUR COOPERATION. <br />NEBRASKA DEPARTMENT OF REVENUE - White and Canary Copies TAXPAVER - Pink Copy COUNTY OFF ICE Goldenrod Copy <br />4.23268 Rev. 5.86 <br />Suuersedes 4.232.66 Rev. 1.81 <br />L J <br />- '1!1�-rt=`�3#r?':F .-�? ��t - 4s=- .,- "».'•.'i. M - �c'Mazr74��tN..r.p�+v.,..r�er rr�zr7C'. <br />