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!I State Tax Lion 87" 101140 t mat Statement of Termination or .eeeNa t!'_aQrtifin9te Af Dsrisi Q —i—ee— :__ Lien Serlai fiumber Document Serial Date of Lien Social Security Number or 5/03/357 Number 10065 3 -18 -85 Federal I,D. Number 507 -54 -4699 Nebraska I.D. Nurhlar County Lien Filed With SPOUSS'S Social Security Deeds Number 3534847 Hall [N CouuntyrCle 505 -52 -6743 BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name Name Brown's Repair Shop Edmund A. & Sharon K. Brown Street Address Street or Other Mailing Address i nt Highway - 30 Box 177 City - State Zip Coda City State Zip Code 'Wood River, NE 68883 Wood River, NE 68883 rurmut to the revenue laws of the State of Nebraska, notice is hereby given that the State Tax Lien which has been daffy - fited by the Nebraska Department of Revenue against the above named taxpayer, is terminated, partially released, or Saban& nafed to the extent indicated below. TYPE OF ACTION R1 TERMINATION OF TAX LIEN. The State Tax Lien is hereby full' terminated - i PARTIAL RELEASE_ The State Tax Lien is partially released as follows. —1- v wiry marring repuest and 11W—Sible for filing certificate of partiaf retease with appropriate tiling Officer. 1 SUBORDINATION. The State Tax Lien is subordinated as follows_ Names of party making request and responsible for filing certificate of subordination with appropriate filing officer. I hereby certify that the Nebraska DeDartment of Rerenue nas Complied with the rersh— taws Of the State Of Nebraska in the determination of the inatWn, partial release O+ Subordination i'thca.M above. - �Z Revenue Agent j r Title - - Date Special Agent -AYSAWiTEs Title Date FOR COUNTY OFFICIAV S USE NEBRASKA DEPARTMENT OF REVENUE — White and Canary Copies TAXPAYER — Pink Copy COUNTY OFFICE — Goldenrod Copy 4- 232.68 Rev. 5 -86 Supersedes 4. 232 -68 Rar_ 1-61 IN J