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�� <br /> � � <br /> State Tax Li�n <br /> ,,,�b Statament nf Termin�tion or <br /> �:�:' Csrtlticate of Pa�4iai Releesa or Subardinatian <br /> L�en Saria�Number oatumant Se�1�1 Pate ot�ia� SocNi S�curNy Number or <br /> A,Oc�FCs NumO�r Fetleral 1.0.Numb�r <br /> 7 � v �3��� �-�s�a� 89-- 106095 <br /> � tYfW�sk�i.D.Numb{r Gounty L ��It�Q Wltn 5navti'1 SoC�A1 Secu�kty <br /> �R�pitter af Osaps Number <br /> 4UI J:J�� �a�� ❑ CountY CurK <br /> eUfINESt NAME Ak0 IOCATiQN AI)DRESS TAXPAYER NAME AND MA141Nti ADDRESS <br /> Bu�Intfs N�m� N+m• <br /> J. H. K.. Inc. <br /> S1nH AtlAnsf Stn�t o►Othor Mallin9 Adtl��u <br /> P.O. �ox 121� <br /> CHy Sate--=-- 21aCOtle Cttv Stab -iRC�no <br /> Grand Island NE 68�Q?_ <br /> Pwswnt to the r�venue lawa of the State of Nebrasla.notice is henby g�en that thc State Tax Lien which has ban du1,�r <br /> fded by the Nebrae{ca Deparnnent of Revenue ssau►st the abuve named taxpayer,is terminated.partlally releaxd�Pi S11I10Idi- <br /> �wtted to the extent indiqted belar+r. <br /> TYPE OF ACTIQN <br /> t� TERMINATION OF TAIf CtEN. 7he State Tax Lien is hereby futly teunL►ated. • <br /> ❑ PARTIAL RELEASE.The State Tax Lien is partially released as faiio�vs. <br /> Name o1 partv mak�ng request antl respans�blo tor tlllnq r.ert�ticate of partla�reaoase wlth apwroorlatC 1I�in9 oTrlter, ' <br /> ❑ SUBORDINATION.The State Tax Llen is subordinatcd as follrnv�. <br /> �_: <br /> �.,, <br /> N�mn ot paTty makin9 request and rCSOa�slbte for f1Ung certHlcate ot suDordinatlon with aDmroprlate ifUng oHieea � <br /> t heMby te►tlfy th�t tho NObraSke Oepartmont ot Revonue Aas eomDlletl wlth the revtnuE lawt ot tlfe St0t0 Ot NCD�aSkO In tha ; <br /> aete►minatlon ot tne terminat�on, ert10)/@1e05e O�subottllnatlOn in�ltitCtl abOVO. <br /> . � :� ` . <br /> ����n Taxpayers Service Specialist �� �-�� <br /> p gn ►e Tttte Date <br /> �1e,, �,,.� Revenue Aqent Supervisor //- 6 �/' <br /> . ! Tmc Oate <br /> e, AuthoNZatl 519natwe <br /> FOR COUNTY OFFICIAL'S USE <br /> ..� ;�� ;� <br /> -r '; <br /> ' �' .' �' � c.. <br /> . « -_ <br /> ':� .. <br /> � <br /> � tY�ifiA3KA bEP!>RTMENT pF REVENUE -White ar,d Canarv CoR�es TAXPAYER-Pink CopV COJNTY OFFICE -Goldenroa Copv w� <br /> �" A1'1'�1� IW�PICS(S� OF TlIX LIlZt (t?R TER!lI�TIOti) IS {ARE) Z'O BE FILED 0lii.Y MITK ,—___-�T_= <br /> zx� �mci� ar ar.sns. � � . <br /> THE DOCUMENT(S) IS (ARE) NOT TO BE FORWARDED TO THE COtJNTY CLERK. <br /> U25TRI8(3TION OF COPIES: ' <br /> WHITE: TO bE VAI.IbA'i'ED BY THE REGISTER OF DEEbS AND RETURNED 'I'O THF. � <br /> � pEPi►RTMENT OF R�IENUE. <br /> GULDENROU: TO SF KEPT AY TNE REGISTEF2 pP DfiF,DS. <br /> BILLING IS TU Afi ONCF. PER MONTN NJD THERE WILL BE NO PRF.-F'AYAlENT OF FF.�;S. ^ <br /> T'NAtIiC YnU POR YOUR CC�PfiW1TTQt7. � <br /> - - -- --�- •----- ---� - r' � <br /> ro. .. <br /> � � <br />