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J <br />Z <br />Itr7. <br />(10 <br />10 002 <br />State Tax Lien Statement of Termination <br />tr <br />Mflretle or Certificate of Partial Release or <br />Subordination <br />el f,VMYe <br />_ <br />07108/2002 16:03 FAX <br />14024714429 <br />NEBRASKA UCC <br />given that the State Tax Lien which has been duly filed by the Nebraska <br />Department ofRereuue against the be low -named taxpaytr, Is terminated, <br />sSgnature <br />partially released, or subordinated to the extent indicated below. <br />Dale Telephone No. <br />oG1 <br />O <br />Social Sacnrlty or Fadaral I.D .Number <br />spouse's Social Securay Number <br />22 <br />502 -84 -1510 <br />510 -62-7103 <br />Uen Barrel Number <br />0560039 <br />as .y <br />Dye of Lien <br />D°RA <br />NEBRA,W <br />�:] Register ofpeatlo � County Clark <br />04- 04 —(]Q <br />HDT•i• <br />Co <br />TAXPAYER NAME AND MAILING ADDRESS <br />BJSYIaae Name _ <br />Name <br />JOHN G & arms J GROSS <br />9reee Address <br />Saeetor Othar Maji ng Address <br />3720 WEST STATE SP A7 <br />City State lip code <br />Cry State apcode <br />C C\1 <br />T <br />O <br />_ <br />:.0 sJ <br />O <br />O <br />c7 Y <br />"u <br />200207164 <br />C\ <br />d <br />N <br />�u <br />J <br />Z <br />Itr7. <br />(10 <br />10 002 <br />State Tax Lien Statement of Termination <br />tr <br />Mflretle or Certificate of Partial Release or <br />Subordination <br />el f,VMYe <br />_ <br />PLEASE DO NOT WRITE IN THE SPACE <br />Pursuant to the revenue laws of the State of Nebraska, notice is hereby <br />release, orsu r'na <br />given that the State Tax Lien which has been duly filed by the Nebraska <br />Department ofRereuue against the be low -named taxpaytr, Is terminated, <br />sSgnature <br />partially released, or subordinated to the extent indicated below. <br />Dale Telephone No. <br />Nebraska ltle�xrkagon Number ' <br />518190 <br />Tax Category <br />Social Sacnrlty or Fadaral I.D .Number <br />spouse's Social Securay Number <br />22 <br />502 -84 -1510 <br />510 -62-7103 <br />Uen Barrel Number <br />0560039 <br />Lien Plied Win <br />Dye of Lien <br />D°RA <br />NEBRA,W <br />�:] Register ofpeatlo � County Clark <br />04- 04 —(]Q <br />HDT•i• <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />BJSYIaae Name _ <br />Name <br />JOHN G & arms J GROSS <br />9reee Address <br />Saeetor Othar Maji ng Address <br />3720 WEST STATE SP A7 <br />City State lip code <br />Cry State apcode <br />GRAND ISLAND NE 68803 <br />TYPE OF ACTION <br />r] TERMINATION F TAX LIEN. The State Tax Lien Is hereby fully terminated. INSTRUMENT NUMBER <br />TAX YE (corporate, Individual income, and withholding tax only) 1996 1997 1998 <br />❑ PARTIAL RELEASE. The Stale Tax Lien is Partially released as follows, INSTRUMENT NUMBER _ <br />TAX YEARS (corporate, Individual Income, and withholding tax only) <br />LD SUBORDINATION. The State Tax lien is subordinated as follows. INSTRUMENT NUMBER <br />Please ream to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF RFYENUE <br />1811 WEST 21D ST STE 460 <br />GRAND ISLAND NE 68803 <br />Name of perry rtvking rsquesl aM responsible for fillrg oarbhcete M partial reieasearsubordinatlon vnN appropriate filing efrror <br />9900044686 <br />I hereby carry that the NcbraSNa DaparlmeB of Reverue has eornpiled etlh the raven laws of" sees of Nsbaaka In the determinelion of the <br />sign4oan.l. <br />release, orsu r'na <br />mndk:atetl above. <br />here <br />sSgnature <br />Tile <br />Dale Telephone No. <br />Author ed n a <br />This <br />'hn9 <br />psi <br />NEBRA,W <br />DFFARTMENrele REVENU <br />and Canary Copies TAXPAYER - Pink Copy <br />COUNIY OFFICE - Goldenrod Copy <br />4.2121 Rer. 8-26 SYpacedoa 4- 212 -aa Re:. I 1 <br />