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<br />1I1'!Wob,.... <br />Ir~1 <br />Llln Slrl.l' Numb., <br /> <br /> <br />State Tax Lien <br />Statement of Termination or <br />Certlflca~e of Partial Release or Subordination <br /> <br />Soclll Slcurllv Numb" or <br />Ped.,.ll,D. Numb.r <br />, <br />Lt.n :-'Utd With SPOUH'. Social Slcurlly <br />Regilt., of DUds Number <br />County Clerk <br /> <br />Oltlol LII" <br /> <br />88- 106930 <br /> <br />l <br /> <br /> <br /> <br />TAXPAYER NAME AND MAILING ADDRESS <br /> <br />Str..t Addrl" <br /> <br />Stltl <br /> <br />Zip Codl City <br /> <br />StaiB <br /> <br />Zip Code <br /> <br />NE <br /> <br />F <br /> <br />NE <br /> <br />68025 <br /> <br />Punuant to the revenue laws of the Slate of Nebraska, noli.. is hereby given thaI the Slate Tax Lien which has been duly <br />fded by Ihe Nebraska Departmenl of Revenue agains1lhe above named taxpayer. is terminated. partiaIly rel....d. or subordi- <br />nated to the extent indicated below. <br /> <br />I ~OF~ON <br />IllJ TERMINATION OF TAX LIEN. The Slote Tax Lien is hereby fully terminated. <br /> <br />o PARTIAL RELEASE. The State Tax Lien 15 partially released 35 follows. <br /> <br />Name of party mdklng request and fll5pOn51bla IOf filing cllrtlflcate of partlal release with appropriate filing offlclr. <br /> <br />o SUBORDINATION. The State Tax Lien is subordinated as follows, <br /> <br />Name of Plrty milking reQUlllt Ind rllQonslblll for tiling certlflcatll of subordination with atlproprlate filing officer. <br /> <br />,:...... <br /> <br />t,ll:~. -. ~..by.:c..r~Uy that'thlt Nebraskl Dllpartment of Rllvenue has complied with the revenue laws of the State of Nebraska In the <br />, deier~lr1ftlon~oHhIl1ermlrilt10n, PIli11~.1 iellll58 or subordination Indicated above. <br /> <br /> <br /> <br /> <br />r..f:&r- <br /> <br /> <br />0' ,., . Authorlzed.Slgnature <br />I: H. . -- <br />4 0 <br /> <br />Rpvp""p Agp"" .. .J. /~.r <br /> <br />IfL ~ .. ~tLn- <br />Title ~~oate, <br />FOR COUNTY OFFICIAL'S USE I <br /> <br />NEBRASKA DEPARTMENT OF REVENUE - White and Canary Copies <br /> <br />TAXPAYER - Pink Copy <br /> <br />COUNTY OFFICE - Goldenrod Copy <br />4\-232.68 Rev. 5.86 <br />Supersedes 4-232'68 Rllv. loB 1 <br /> <br />-,' <br /> <br />.y <br /> <br />L <br />