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r State Tax Lien �,. Statement of Termination or tmeht /+Ak1Pi1Hw4ft4A1k ws dsIP&lw>I w: ■■i�w..Eiwwttiw� Porsnant to the revalue lbws of the State of Nebra", tatke is Wetly &en thAt the State Tax Lieu which has been duly Sled by the Nebrai a Department of Revenue apiost the above named tt xp flyer, is terminated, partially released. or subordi- a t 4,to thei,extmt indicated below. i 17,77 TYPE OF ACT40M © 71;0111AQNATiONnf TAX UM The State Ta Lien is hemby fulky terminated. ❑ PARTIAL RELEASE. The State Tax Lien is initially released as follows. t. Nam& of party. making rawest and responsible for filing certificate of pattim release oath appropriate. flung officer, - ❑ SU60RDINATION. The State Tax Lien is subordinated as foilows. f — i Name of party making request and responsible for filing Certificate of subordination with appropriate filing officer. 1 hereby Certify that the N braska Department of Revenue has compiled with the revenue laws of the State of Nebraska In the determination of the termination, Mal release or subordination Indicated above. sign Taxpayers Service Specialist :� MIN n ure Title Date 41 Revenue Agent Supervisor y - Orised Slonstur Title Date r FOR COUNTY OFFICIAL'S USE NEBRASKA DEPARTMENT OF REVENUE - White and Canary Copies TAXPAYER —Pink Copy COUNTY OFFICE — G9fdenrod Copy . W THE ATTACUD MD't =CE OF, STATE TUC LIlN 'TiE 1lINATIC U SHOuLD� : BE FILED WITH RWr_E,; THE f0 i2STER Or DEEDS AND THE COUPITY CLERK.... THIS IS TO TER"IttATE THE.bIEN(S) FILED PRIOR-TO J.• - 27, 1986 WIT:! BOTH OFFICES. THE REGISTER OF DEEDS IS REQUESTED TO FORWARD THE DOCUMEMrs TO THE COU7ITY CLERK. DISTiRIBUTION OF COPIES: LWHITEt TO BE VALIDATED BY BOTH THE REGISTER OF DEEDS AND THE COUNTY CLERK AND RETURNED TO THE NEBRASKA DEPARTMENT OF REVENUE. CANARY: TO BE KEPT BY THE REGISTER OF DEEDS-. GOLDENROD- TO BE KEPT BY THE COUNTY CLERK. THEM IS NO FEE TO BE CHARGED FOR A TERMINATION NO'T'ICE. w THANK YOU FOR YOUR COOPERATION. . -1 ,a. . r .�.�� . .�ra■rMw �.■■■eww■ve■ Lien Serial Number Document Serial Date of glen Social Sesurlty, Number or 6/01/829 Number 12916 1,8 -86 Federal I.D. Number 06- 82.087te 4 is Nebraska I.D. Number County l,�in Flied With Spou'a Social Security �7j Rbplater of Deetla Number 4515285 Hall []I County Clerk EUfINEU NAME AND LOCATION ADDRESS TAXPAYER. NAME AND VAIIJO AW?RM ausiness Name Name Jefferson Repair Greg 0nnen Street Addreas Street or Other fMWAIntl Address 346 North Jefferson 113 CentC Lane City State zip Coale City. State zip Code Grand Island NE 68801 Aida, NE 68810 Porsnant to the revalue lbws of the State of Nebra", tatke is Wetly &en thAt the State Tax Lieu which has been duly Sled by the Nebrai a Department of Revenue apiost the above named tt xp flyer, is terminated, partially released. or subordi- a t 4,to thei,extmt indicated below. i 17,77 TYPE OF ACT40M © 71;0111AQNATiONnf TAX UM The State Ta Lien is hemby fulky terminated. ❑ PARTIAL RELEASE. The State Tax Lien is initially released as follows. t. Nam& of party. making rawest and responsible for filing certificate of pattim release oath appropriate. flung officer, - ❑ SU60RDINATION. The State Tax Lien is subordinated as foilows. f — i Name of party making request and responsible for filing Certificate of subordination with appropriate filing officer. 1 hereby Certify that the N braska Department of Revenue has compiled with the revenue laws of the State of Nebraska In the determination of the termination, Mal release or subordination Indicated above. sign Taxpayers Service Specialist :� MIN n ure Title Date 41 Revenue Agent Supervisor y - Orised Slonstur Title Date r FOR COUNTY OFFICIAL'S USE NEBRASKA DEPARTMENT OF REVENUE - White and Canary Copies TAXPAYER —Pink Copy COUNTY OFFICE — G9fdenrod Copy . W THE ATTACUD MD't =CE OF, STATE TUC LIlN 'TiE 1lINATIC U SHOuLD� : BE FILED WITH RWr_E,; THE f0 i2STER Or DEEDS AND THE COUPITY CLERK.... THIS IS TO TER"IttATE THE.bIEN(S) FILED PRIOR-TO J.• - 27, 1986 WIT:! BOTH OFFICES. THE REGISTER OF DEEDS IS REQUESTED TO FORWARD THE DOCUMEMrs TO THE COU7ITY CLERK. DISTiRIBUTION OF COPIES: LWHITEt TO BE VALIDATED BY BOTH THE REGISTER OF DEEDS AND THE COUNTY CLERK AND RETURNED TO THE NEBRASKA DEPARTMENT OF REVENUE. CANARY: TO BE KEPT BY THE REGISTER OF DEEDS-. GOLDENROD- TO BE KEPT BY THE COUNTY CLERK. THEM IS NO FEE TO BE CHARGED FOR A TERMINATION NO'T'ICE. w THANK YOU FOR YOUR COOPERATION. . -1 ,a. . r