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� n � <br /> fl l� Z rn SI �" <br /> . <br /> � _ � c,�o o -�i ^1� <br /> c n �� � z `i �� -, <br /> �� � � rn � <br /> rn "c -� c� �Q' Ci, <br /> � p "*t 1 41 <br /> � � � � � � � <br /> � � S �T1 � <br /> �'1 � xs' O] � .-Ny. <br /> ^' � r`-- n ;,,� c� <br /> 9 - st�4ss�. � � � � � <br /> D fJ1 ,,,�y,� <br /> ""� v? �+ O <br /> � State Tax Lien Staternent of Te�f'nination _�- <br /> �Iror Certificate of Partial Release or � <br /> nabnska � <br /> ��•M Subordination <br /> of rwanw <br /> PLEASE DO NOT WRITE IN THIS SPACE <br /> Pursuant to the revenue laws of the State of Nebraska,notice is hereby <br /> given t6at the State Tax Lien whic6 has been duly filed by the Nebraska <br /> Department of Revenue against the below-named taxpayer,is terminated, <br /> partially released,or subordinated to the extent indicated below. <br /> Nebraska Identification Number Tax Category Social Security or Federal I.D.Number Spouse's Social Security Number <br /> 7697651 1 -24- 1 2 <br /> Lien Serial Number Lien Filed With Date of Lien County <br /> 8 12 61 esister ot�eeds ❑county c�erk O 1—0 6—9 9 HALL <br /> BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br /> Business Name Name <br /> MILTON & KELLY DAVIS <br /> Street Address Street or Other Mailing Address <br /> 1233 E WATSON DR <br /> City State Zip Code City State Zip Code <br /> TEMPE AZ 85283-3159 <br /> TYPE OF ACTION <br /> �TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. INSTRUMENT NUMBER ��k��.�l�� 99-100843 <br /> TAX YEARS (corporate, individual income, and withholding tax only) <br /> ❑PARTIAL 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 /> Name of paAy making request and responsible for filing certificate of partial release or subordination with appropriate filing officer. <br /> I hereby certify that the Nebr Department of Revenue has complied with the revenue laws of the State of Nebraska in the determination of the <br /> terminati n,partiai release,or r nation indicated above. <br /> siJn ' � �.�9-9� ����-���- <br /> here reparer's na re. Title Date Tel �phoneNo. <br /> Q�� Authorize ignature e Dates� � <br /> NEBRASKA DEPARTMENT OF REVENUE-White and Canary Copies TAXPAYER-Pink Copy COUNTY OFFICE-Goldenrod Copy <br /> 4232-68 Rev.&96 Supersedes 4232-68 Rev.10-95 <br />