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look <br />W <br />AD <br />I� <br />- 1` <br />F <br />State Tax Lien <br />Statent Ot of Termination or <br />►«« . <br />cernricat* <br />of pa <br />tis Reieaas or Subordination <br />Lien Sertal Number <br />Docurnent Se►lai <br />Date of Lien <br />-Social security member or <br />88253040 <br />Number <br />13056 <br />9J9j86 <br />Federal I.D. Num t . <br />9Z- .4Q- 7if��;::. <br />89-_ O <br />- <br />Nebraska /.D. Number <br />10702644 <br />County <br />Wdll - - <br />Aden Filed with ` _ <br />Register ofDeeds <br />Saab•. -+ <br />Number <br />0 county clerk <br />224 -72 -6800 <br />SUSINESS NAME AND LOCATION <br />ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Nam <br />lyre <br />:Richard" L. ;i� �' �.ade��'��rre M Retal l " <br />..... iLK; <br />strost.a <br />Street or Other Mil ?.sr <br />2426 west I:a4a*, Stre$t. <br />;%.DES',. 'r'ij. <br />- .�.:'''•'t' Zip Cade <br />City ...' State Zip Code <br />Grand Island NE 68801 <br />Pwm-nt tt fine revenue laws Of the State of Nebra*a, notice is hereby &tn that the State Tax Lien which has ban daily <br />filed by GO Nebm" Department of Remnue evinst the abom named taxpayer, is temnitoted, partially released, or aabordi- <br />toted to t6a extent indicated below.. <br />TYPE OF ACTION <br />K] TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. <br />❑ PARTIAL RELEASE. The State Tax Lien is partially released as follows. <br />Name of party making request and responsible for filing certificate of partial release with appropriate filing officer. <br />❑ SUBORDINATION. The State Tax Lien is subordinated as follows. <br />Name of party makfn- 1-mquest and responsible for f9]7r4 certificate of sutsordinaetcr.. with appropriate filing officer. <br />e <br />1 hereby certify that the Nebraska Departmc -it: cr Revenue has compiled with the revenue lavfs of the Sta:e of Nebraska In the <br />determination of the termination, partial release ory lar:inatlon Indicated above. <br />sign ;, Revenue Agent Supervisor <br />here epar.rf► g slurs evenue Agent Supervisor D'1 <br />_Y f <br />Authofined Signature Title Dabe <br />FOR COUNTY OFFICIAL' S USE <br />NEBRASKA DEPARTMENT OF REVENJ5 -- ViNte and Canary Copies <br />TAXPAYER - Pink Cop,,, COUNTY OFFICE - Goldenrod Copy <br />4.232 -68 Rev. 5.36 <br />Suaersc:;es 4.232.68 Rev. 1.81 <br />L <br />