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� � <br /> State Tax Lien <br /> Statement of Termi��tion or <br /> ..r:�:: Certificat� oi Parti�al Release or Subordination __ <br /> � L�tn Str111 Numt»r C1�.cument�ia:ia! Oatv ut�.�uw Snc4�1 SncurlYy Numhcr or <br /> ryumuer Peacra� I.Q.Numper <br /> � � 9 10 669 �3��0 ��-�o�ss - - gg 10�g7� <br /> N�nciskd I.p.Num�er f:ountv len F11�0 Witn Spouse's Soe�a�5ecurity �� <br /> , � Raqister of pseas Numdo• ' <br /> Hal l �Cuunty Clork <br /> 6t1SINE�B HAME AND IOCATION ADDRESS TAXPAYER NAMH ANO MAIIIN�AODRESS <br /> Businefs Nam� Nama • <br /> •. <br /> S1rNt AOOnu Struet a Other Mailinq Atlqtess <br /> CItY 5tata 2ip CoC¢ Clty Stats Zip Catls <br /> Purauant to the revenue Isws of the State of Nebraska,notice i.s herebv gi�en that the State Tax Lien whlch hu ban dWy <br /> filed by ihe Nebra�{ca Department of Re�Ynue againse the above nuned taxpa}er.is terminated.putiaUy�e�eaxd.or subordi- <br /> mted to thr extent indicated bebw. � <br /> TYPE OF ACTION <br /> Q TEHMINATION OF TAX LIEN. Thc Statc Ta�L�r.c as�a�c4i�}�fi�11�•tcnninatcJ. <br /> 0 PARTIAl.RELEASE. Thc Statc 1'ax Lic�t is partially rcleascd as f�llu�vs. <br /> Name ot partY mak�og request and respons�bte for f�Vir.q cer..�,cate o1 partial role�so.vith apDropriMe tillnq olficer. - <br /> } '. <br /> tf <br /> ❑ SUBORQINATION. The Statc�'ax Licn is subordinated a;f�ti!uu•x. • _ <br /> �.: :;_ <br /> i =•r•- <br /> f L <br /> . f� <br /> t <br /> Name ot party meklnq request a�C re,por.sitr�v`or tlling Ce�tl}It�te ot fubo�dinatlon�vlth�pproprlat8 flling oHit�►. <br /> 1 hf►!Dy ClrtHy that thC NQb►d9k3 `Jal:ar!mCnt ot RevCnue ha5 complietl wlth th0�OVenuC lawf Ut thD StitE ot NebTaSka If1 th� <br /> tlet�rmin�tlon ot the terminatl n.Aift181(e;035E OT SUdOttl1�0110P In01CdtCU 8bOV0. � <br /> - ��� <br /> s1�11 T — <br /> . �� 's Sl9nat � T it�c % �� � <br /> � � � — <br /> •• utnoriz�d Sly�ature T�t�o Date � <br /> FOR COUNTY OFFICIAL'S U5E !'1n' <br /> .� <br /> : <br /> . r —. <br /> . � <br /> NEgFiASKA OEPARTMENT OF REVENUE• White and Canarv Con�es tAXPAYER - P�nk Copy COU�7`/OFFICE -� GolHenrod CoPY <br /> T�[E 111"TItiCHED t�i0T2C=�8) O'P TlilC LIQt (OR TSRMZNRTION) IS (ARE) TO 8E FILED C7rfLY MI'i41 •-- -�— <br /> '111i �I!'!�R a!' lf�. <br /> THE DOCUI4ENT(S) IS (ARE) NOT TO BE FORWARDED TO THE CUUNTY CLERK. <br /> DISTRIBt3TIUN OF COPIES: � <br /> WHITE: • TO BE VALIpATE;D BY THE RF•GISTER OF DEF.DS AND RE�'llRNED TO TNE � <br /> LUFPARTMENT OF R�17F.NUE. <br /> GC)LDENROD. 'I'O BE KEPT F3X T7(E RF.GISm�R OF DEEUS. � <br /> AIL,I.ING 2S TO AE ONCE FF,R f40NTFI AtJD 'T1iERE WI1.T, HF. N4 I`F2F-1'AY;�1F'NT (JF' EF.FS. It'� <br /> . <br /> 'I'HAl7K YCYU F�)k Yf1UR C(N�Ph:R11'I'It�t7. �`� <br /> � � <br /> , <br /> � � <br />