Laserfiche WebLink
<br />NEBRASKA Dee <br /> <br />14I 003/009 <br /> <br />10/03/2006 16:35 FAX 14024714429 <br /> <br />Plelllle return to; <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1 g 11 WEST 2ND 8T 8TE 460 <br />GRAND ISLAND NE 68803 <br /> <br />200608909 <br /> <br />'\\\\\\~I"I <br /> <br /> <br />9906413333-5 <br />HOOGH M!~I:aI2006 02:14 P" <br />Fl.l.d: ,,, - <br /> <br />0fD <br /> <br />~ <br /> <br /> <br />State Tax Lien Statement of Termination <br />or Certificate of Partial Release or <br />Subordination <br /> <br />I'l,*r~"t <br />cl,,,""a~ <br />qf ,.....!Wi <br /> <br /> " PLEASE DO NOT WRITE IN THIS SPACE <br /> I <br /> Pursuant to the revenue laws of the State,bf Nebraska, no~ice Is hereby <br /> given that the State Tax lien which has b~en duly filed by the Nebraska <br /> Department of Revenue against the beloW:-named taxpayer, is <br /> terminated, partially released, or subordln:ited to the extent indicated <br /> below. <br /> , , <br /> Nebraska Idenlificat'lon Number Federalldenllficallon Number Social Security Number Spouse's Social Security Number <br /> 8390754 506-11,.7433 <br /> Lien Serial Nu'mber ,Lien ~leQ wilh ' '.- , ' .. Dale of Lien Tax CategolY County <br /> " 3/07/401 ' t~lRe~isIBr o(De~s '0 Co'unty Clerk' 07/1212003 0121 ,Hail <br /> " <br />r BUSINESS NAME AND LOCATION AD~RESS " ' , TAXPAYER NAME'AND'MAIUNG ADDRESS" " , .. <br />Business Name . ' " ' Name ' .. <br /> " Mia M Hough <br /> : <br />Street Address , Slreet or Mailing Address <br /> : 120 E Third Street <br />City Slate Zip Code City State Zip Code <br /> Grand Island ; NE 6880' <br />1 Type of Action I <br /> ..., <br /> <br />UCt: Instrument Number (9903~8672.2:Q~ j <br />County Instrum'ent Number 200309468 <br />2002/2003 <br /> <br />'[K]', ,TERMINATION OF TAX LIEN. The State Tax, Lien Is hereby fully terminated. <br />! <br />J <br />TAX YEARS (corporate, IndIvidual Income, and withholding tax only) <br /> <br />I <br />D PARTIAL RELEASE. The State Tax Lisp Is partially released as follows: <br /> <br />,! , <br />, TAX Y~ARS (corporate; individual Income, and'wlthholding tax only) <br />i <br />D ,SUBORDINATION. The Stale Tax Lien is subordinated as follows. <br /> <br />UCC InstrumenfNumbsr <br />County Instrument Number <br /> <br />UCC Instrument'Number <br />County Instrument Number <br /> <br />. ' <br /> <br />, I hereby certify lhatthe Nebraska pepartment of Revenue has complied with the revenue laws of the'State of Nebraska in <br />determination of the termination, partial release, or subordimJtlon indicated above. , <br /> <br />" , I <br /> <br />sign "" <br />her~ <br />.. <br /> <br /> <br />Revenue. Senior Agent <br />Title <br /> <br />Revenue Supervisor <br />Title <br /> <br />q/ !HI/Iff:, <br />Dale <br /> <br />308 385-6073 <br />Telephone Number <br />'9A1a6 <br /> <br />O'ate <br />4-232-68 RlIV, 8-96 supelBedes 4-23HIB Rev, 10-95 <br /> <br />v <br />