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� � <br /> Stats Tax Lien <br /> Staten�nt of Terminetio� or <br /> p �»' Certificate ot Partial R�I�as� or Subordlnation <br /> L.ltn Serl�l Numeer t�eCUmen�S�rtat O�t�ot L.��n Soct�1 S�curfty Numfl�r or <br /> n NumWr F�C�ral 1.p.Num¢�r <br /> . 7�����G7� ' � .. <br /> t�NDrask�I.D.Numtl�r County Ll�n Flt�d Wllh SDOUS�'f Soctal SiCUrlty � ���OA w <br /> �J Rpift�r ot DNCE NumW► �V�� <br /> 524�33� Nal] ❑County Ct�rk <br /> el1tlNEii NANiE AND�OCATION AQOpES9 TAX�AYER NAMB ANO MAILINO AOORESS <br /> Buirn�sf Nim� N�mt a�et . eorge <br /> a k a J�net M. Sheetz <br /> Sir��t Adtlnsf St�Nt or Oth�r M�Iilnp Aeltlasf <br /> 3111 West Col e e #�38 <br /> City stat• ztp coa� clty stat• ztp coa. <br /> Grand Island NE 58803 <br /> Pursuant to the revenne liws af the State of Nebnslu.notla is hercby given that the State Tax l.ien which has been duly <br /> fiied by tlte'Nebntka Departmrnt af Revenue a�aL�st the above named taxpsyer,is terminated,partially releaxd�or subordt- <br /> ii31�s LiI��c�i�Iii�'iii�i�:�Y�' Z►c=OW. <br /> 'iMPE OF ACTION • <br /> � �� TERMIAIATION OF TAX�fEN. T�se Scste Tat Lien is hercby fuIIy te�i.naced. ' <br /> ; e� PARTtAL REI.EASE,The State�'a�Li�n is�artially released as fo1lo�WS. � <br /> , Name o�aarty mak�aq request ana resaonsm�e tor�Uinq cert�tiate ot oa�tta�reiease with appropriata filinq otticer. <br /> 1 <br /> ,[7 SUBOROINATION.The Statc Tax Llen Is subordinatcd as follows. <br /> i <br /> ` �� <br /> k � �• �,; <br /> •ram�ot party p r�qu�ft antl r�fpo�sibt�tor 11t1n9 c�rtlticate of subortllnatlon wit�approprlate t111ng otfic�r. • ti <br /> .� � ;� , <br /> • .) h%f�by t�rtify th�t th! NfGfifki pepaitment ot Ravenue haf eamplteO with the nv�nue laws ot th�State of Nebrask�In th� <br /> C�t�/mFMtion ot tn�terml�atlon,D�ttl�l retease or Subortlinatton InOicatetl abova. <br /> . ' � <br /> .; �� . <br /> �'= Taxpayers S���rice Specjalist /�,��� <br /> ���. • r•� atun Tltle Dat� <br /> Revenue Agen� Supervisor /G3-r� . <br /> Authoris�d 519natun Tttle Dat� <br /> FOR COUNTY OFFICIAL'S USE ' <br /> �''- <br /> i: <br /> hEORASKA dEPRtiTMENT QF RFVENUE--White,pnd Canarx Copies � TAXPAYER-Vink Copy COUNTY OFF10E - Galdenrod Copy _ <br /> _ . .,.:...�..�.__..�_.,...._._..._.`...- -� <br /> "' ' • �=- -- _ <br /> 17l� �TT11C�l8D MOTZCR(&�.:t7iR' T1lJ[ tr�EN IOR.�$PMItiATION� IS (ARE) TO BE FILED p�Q.Y 1tlY�ii ` ' � • ". <br /> '!!� �aIl�'� 0!. El��lB": '•': • ; ' <br /> THE .DO�CUt�iT(S) IS (AREy NOT TQ SE FORWARDED TO TFiE CQUNTY CLERK. � � <br /> OISTRIBUTI(Xi QF COPIESt . , . <br /> WHITE: TO BE VP�LIDATED BY THE REGZSTER OF DE£[2S AND F�Tt)RNED TO THE <br /> LDEPARTM�I3T OF REVENUE. <br /> GOLDENRUUs TO SE lC�P'C SY �'HE REGISTE�t OF DE&:DS. ^ <br /> BILLZt.G IS TU B$ O2JCE PER 6i0i37'N lU1D fiiiERE WZLL BE NO P}2�-PAYDIEN'1' GF' f'f:Es. <br /> T41ht7K YOU FOR YdUt2 CttOpERl�mint7. � V <br /> L.� .�.. <br />