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I re afka <br />t <br />trirfa, <br />o revenue <br />State Tax Lien <br />Statement of Termination or <br />rA%Vtifiea!Mfe of Darfial Deln.a - - _a.e -- <br />Lien Serial Number <br />Document Serial <br />Date of Lien <br />Social Security Number or <br />1 florally certify that the Nebraska Departmeht U: Revenge has comoiied with the re Ven.e ia— of the State of Nebraska in the <br />uetdmPlatbn Pf the terminatfon, partial release err suaercin.ri— ireicated aoave. <br />5/03/359 <br />Number <br />10209 <br />3 -19 -85 <br />Federal I.D. Number <br />Special Agent <br />3 -31 -87 <br />Date <br />_ <br />-:tie <br />505 -64 -1482 <br />i (1f "1'5;� <br />Nebraska I.D. Number <br />County <br />Lien Filed With <br />Spouse's So I Security <br />4396634 <br />Hall <br />6o Register of Deeds <br />Number <br />® County Clerk <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />Name <br />Leisure Distribution d /b /a The Recroom Shoppe <br />A <br />Gade <br />Street Address <br />Street or Other Mailing Address <br />2228 N. Webb Rd. <br />1 <br />City State <br />Zip Code <br />City <br />State Zip Code <br />Grand Island NE <br />68801 <br />Island, <br />NE 68801 <br />r'tusuant to the revenue laws of the State of Nebraska, notice is hereby given that the State Tax Lien which has been duly <br />filed by the Nebraska Department of Revenue against the above named taxpayer, is terminated, partially released, or sublardi- <br />uated to the extent indicated below_ <br />TYPE OF ACTION <br />i4 TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terrniraled_ <br />PARTIAL RELEASE. The State Tax Lien is partially released as follows_ <br />Name of Party making reduest and resPOns:ble for filing certificate of partial re W. -'wr: appropriate filing officer. <br />L SUBORDINATION. The State Tax Lien is subordinated as follows- <br />Name of party making requer. and responsible for filing certificate pf subordinat — with a oi,a ia*.e filing officer <br />a <br />- <br />1 florally certify that the Nebraska Departmeht U: Revenge has comoiied with the re Ven.e ia— of the State of Nebraska in the <br />uetdmPlatbn Pf the terminatfon, partial release err suaercin.ri— ireicated aoave. <br />Special Agent <br />3 -31 -87 <br />Date <br />_ <br />-:tie <br />Spmial Agent <br />3 -31 -87 <br />Authorized @lure <br />Title <br />Date <br />FOR COUNT V nFCfri a l• c i Icn <br />w <br />vconiaar ra UerAff IMtN I Uh REVENUE - White and Canary Copies TAXPAYER - Pink Cony COUNTY OFFICE - Goldenrod Coco <br />4-232 sa Rev. ? -ab <br />Sgcersedes <br />4- 23268 Rev. i -8i <br />a <br />L� <br />