|
<br />01/29/2007 1~:05 FAX 14024714429
<br />
<br />NEBRASKA Dee
<br />
<br />III 002/002
<br />
<br />()v
<br />
<br />
<br />TD!
<br />
<br />200700716
<br />
<br />PSIS: 1
<br />
<br />I Please Return Original CORY to the
<br />" Nebraska Dept of Revenue'at 200
<br />South Silber, North Platte, NE
<br />69101 .
<br />
<br />'"
<br />_1U~
<br />dePClIIriIIM
<br />0( I'4WfRII
<br />
<br />S~te Tax Lien Statement of Termination
<br />or Certificate of Partial Release or
<br />Subordination
<br />
<br /> PLEASE DO ~OT WRITE,IN THIS SPACE
<br /> Pursuant to the revenue laws of the State of Nebraska, notice is hereby
<br />given that the State Tax Lien whlc;h has been duly filed by the Nebraska
<br /> Department of Revenue against the below-named ,taxpayer, Is .
<br />tennlnated, partially released, or subordinated to the extent Indicated
<br /> below.
<br />Nebraska Identification Number Federal Identification Number Social Security Number Spouse's Social Security Number
<br /> 35596090 . 606-46-1281
<br /> Lien Serial Number Uen filed with Date of Lien Tax Category . County
<br /> ~ .. ..' .' ~ Rl:l9i8t~r ~f ,Deeds '0 County Clerk' 04/1 8/2003 22 . '.. ..,
<br /> 30870140 HALL . , ,,01' ..
<br />r B1;JSINESS:NAME.AND l.OCATlON ADDRESS ".'L TAXPAYER NAM~ AND MAILING ADDRESS
<br />Business Name, . ,~'." '. . . . , . Na~e ' , ' , ;" , . ~:. ,'.; ~"', -' . - . ., ~ . ..' '!
<br />.. . , .. . . /
<br /> _. ,_J,"',' ','I
<br /> - ,'", SINAKHONE SIRIPHONE
<br /> Stre~J.Address Street or Mailing Address
<br /> 2023 W 3RD ST
<br />City state Zip Code City State Zip Code
<br /> .' GRAND ISLAND NE 68803
<br />r Type of Action I
<br />l!l TERMINATION' OF TAX LIEN. The Slate Tax Lien i~ hereby fully terminated. UCC Instru,:"ent Number C 9903274643 5--:5
<br />
<br />TAX YEARS (corporate, Individual, income, and withholding tax only)
<br />
<br />. County Instrument Number 200305922
<br />1999,2000,2001
<br />
<br />.0 PARTIAL RELEASE.
<br />
<br />The State Tax Lien Is. partially released as follows:
<br />
<br />UCC Instrument Number
<br />COunty Instrument Number
<br />
<br />TAX YEARS (corporate, ,Individual Income, and withholdIng tax only)
<br />
<br />o SUBO~DINATlON.
<br />
<br />The Stale Tax Lien ~ suborainated as follows.
<br />
<br />UCC Instrument Number
<br />County Instrument Number
<br />
<br />\ :J." ,'"
<br />
<br />._1 hereby. certify .that the f\lebraska ,Department tlf Revenulil. h~~_complled with the rev.enue laws of t~e Stale of Nebraska in
<br />de minationof thetermina' n,.partial.release, or subordination indicated above. :, -. - ,,-_: ...:;::'.:~~.,:"',:,.[.::..",:"",:."'.,:,,,;;:;,.:""
<br />
<br />._...c....u..... ',n_" ,'.' ,n : (ZS--{)'l
<br />
<br />Date. '
<br />
<br />
<br />. .. -~ -. ~ .-~.
<br />308 535-8294
<br />Telephone Number
<br />1- .21~-tP)
<br />Date /'
<br />
<br />(j
<br />
<br />sign.... ".,'
<br />her~
<br />....
<br />
<br />
<br />4.232.a1l Rev, e-86 Sup.,..edes 4-232-69 Rev. 10.95
<br />
|