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10!17 /2001 16:30 FAX 14024714429 NEBRASKA UCC <br />} <br />200110632 <br />Ca 006/009 <br />NC 1�4 .f 14410 - uec iN <br />8901172449 -6 Pas: 1 <br />Flied 500171 001a03A2 PM <br />State Tax Lien Statement of Termination <br />Ir or Certificate of Partial Release or <br />„ �� Subordination <br />n nvmw <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Pursuant to the revenue laws of the State of Nebraska, notice is hereby <br />given that the State Tax Uea which has been duly filed by the Nebraska <br />Department efRevenue againstthe below -named taxpayer,is terminated, <br />pr<rdally released, or subordinated to the extent indicated below. <br />Nebraska Identification Number <br />Tax Category <br />506W Security or Federal I.D. Number <br />9pouse's so" Security Number <br />24010707 <br />22 <br />455 -06 -8173 <br />Uen Serial Number <br />Lien Fled With <br />Ciaegisterof Deede [ycountyclerk <br />Cato of Lien <br />06-28-85 <br />County <br />HALL <br />85179030 <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAIUNG ADDRESS <br />Business Name <br />Name <br />FILIBERTO J & ROSE M OLIVARES <br />Street Address <br />Street or Other Maiing Address <br />303 EAST FOURTH STREET, APT 4 <br />aty State Zp Code <br />City state Zr C e <br />680 <br />GRAND ISLAND NE <br />TYPE OF ACTION <br />&TERMINATION F TAX LIEN. The State Tax Lien is hereby fully terminated. INSTRUMENT NUMBER., 90, -1 0147103 -20 �9Q <br />TA_ 1fEARSTorporate, individual income, and withholding lax only) V'? D JUU -T -r o% <br />❑ P ARTL AL RELEASE. The State Tax Lien is partially released as follows. INSTRUMENT NUMBER <br />TAX YEARS (corporate, individual Income, and withholding tax only) <br />❑ SUBORDINATION. The State Tax Lien is subordinated as follows. INSTRUMENT NUMBER <br />Please return to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2T1p ST STE 460 <br />GRAND ISLAND NE 68803 <br />Name of party r aklm request and responsible for filing 0ertflcate of partial reloaee or subordination with appropriate filing officer. <br />I hereby oWft that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in the determination of the <br />twminaft% partial release. oisubordinavindicaw ebove. <br />sign <br />here <br />NEBRASKA <br />Title y <br />Thi- le „y„ <br />COUNTY OFFICE - Goldenrod Copy <br />4.232.0 Rev. 6-90 Supw __ +2324e R.v. 10.9 <br />Vd 3r %lid; <br />Telephone No. <br />VA rrhd Canary Copies TAXPAYER - Pink Copy <br />