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Ift <br />10/13/2000 14:51 FAX 14024714429 <br />NEBRASKA DCC <br />200008 69 <br />12 002 !002 <br />NC !ut of lla /U Ucc e� <br />1 111111 IIIII IIIII IIIII Illii IIIII IIII III <br />9900089539 PBS I <br />LIVINGSTON LORI <br />Filed, 10/13/2000 12:23 PM <br />State Tax Lien Statement of Termination <br />Mfr or Certificate of Partial Release or <br />nebrae"' Subordination <br />depo falent <br />of rovw" <br />PLEASE DO NOT WRITE IN 71118 SPACE <br />Pursuant to the revenue laws of the State of Nebraska, notice is hereby <br />given that the State Tax Lien which has been duly filed by the Nebraska <br />Department of Revenue against the below -named taxpayer, is terminated, <br />partially released, or subordinated to the extent indicated below. <br />Nebraska Identirication Number Tax Category Social Security or Federal I.D. Number Spouse's social Security Number <br />7722303 01 & 21 5U1— 6 -31 6 <br />Lien Serial Number Lien Fled With Date of L[on County <br />9 0 6 3 5 8 <br />Register of Deeds ❑ county clerk 0 6 —15 —19 <br />BUSINE53 NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />- - -- - -- Name <br />Address <br />Zip rode <br />Sloe ap <br />TYPE OF ACTION <br />TERMINA ON 0 TAX LIEN, Tile State Tax Lien is hereby fully terminated. INSTRUMENT NUMBER <br />99- 106248 1 x16_22 <br />--- {N-1"�(corporate, Individual Income, and withholding tax only) <br />PARTIAL RELEASE. The State Tax Lien is partially released as follows. INSTRUMENT NUMBER <br />TAX YEARS (corporate, Individual income, end withholding tax only) <br />❑ SUBORDINATION. The State Tax Lien is subordinated as follows, INSTRUMENT NUMBER <br />Return to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE -- <br />1811 WEST 2ND ST GTE 460 <br />GRAND ISLAND NE 68803 <br />Name of party making request and respansiole for Hang certificate of partial release or subordination with appropriate ftfing otticer. <br />I her" cartfly thatthe Nebraska Department of Revenue has plod with the revenue laws of the Slate of Nebraska ir the determination of the <br />temtlnatio partial re ease, or ubordin lion indicated above. <br />sign - <br />eo - <br />Teiephone o. <br />here fne rers amore , J 1 <br />lwtflori: 6 atu <br />Tae Qar <br />NEBRASKA DEPARTIVIE OF REVENUE While and Canary Copies TAXPAYER Pink Copy COUNTY OFFICE - Goldenrod Copy <br />4292 -68 Rev. 6.96 S„ paraWea 4 232.69 Rev. 10- <br />