200502232 - Laserfiche WebLink

Browse

03/15/2005 17:05 FAX 14Q24.714429 NEBRASKA UCC Q003/003 . f'7 20050223; State'Tax Lien Statement of Termination or Certificate of Partial Release or Subordination PLEASE DO NOT WRITE IN THIS SPACE Pursuant to the revenue laws of the State of Nebraska, notice is hereby given that the State Tax Lien which has been duly filed by the Nebraska Department of Revenue against the below -named taxpayer, is terminated, partially released, or subordinated to the extent indicated below. Nebraska Identification Number Federal Identification Number Social Security Number Spouse's Social Security Number 6364055 507 -76 -2114 Lien Serial Number Lien filed with Date of lien Tax Category County 1/05/874 x0 Register of Deeds [] County Clerk 5 -15 -1991 94 Hall BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name Name Ms. Donna M. Barger Street Address Street or Mailing Address 2703 South Engleman Road City State Zip Code City State Zip Code Grand Island NE 68801 Type of Action f 4 • TERMINATION OF TAX LIEN. The State Tax Lien is hereby fuily terminated TAX YEARS (corporate, individual income, and withholding tax only) ❑ PARTIAL RELEASE. The State Tax Lien is partially released as follows: TAX YEARS (corporate, individual Income, and withholding tax only) UCC Instrument Number 0896100583 County Instrument Number 96- •100583 UCC Instrument Number County Instrument Number ❑ SUBORDINATION. The State Tax Lien is subordinated as follows- UCC Instrument Number County Instrument Number I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in determination of the termination, partial release, or subordination indicated above. sign 110. 402 471 -5709 here pre rer's Sig t Tile Dale Telep ne umber 1,219 i Revenue Senior A ent Q d aak uth 717 ig Title a 4 -232-66 Rev. 6-96 supersedes 4- 232 -99 Rev. 1 x-55 T f