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State Tex Lien <br />Statement of Termination or <br />` if -, _te of Parti&I Release or Subordination <br />Llan Aerial Number <br />Orteumani Seflol _. <br />pate of Lion <br />Social Security Niontrar or.... <br />'M <br />w {xij 0..... <br />-.... 7. _ 103900 <br />3/11/2" <br />714 5 <br />11 -01 -83 <br />=i544 V' <br />Noeratka I.D. NUM"r <br />County <br />Piled With <br />Spouse's Social Security <br />2� <br />�a11 <br />Register of Deeds <br />In <br />Number <br />County Clark <br />NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Nama rna _ ark orath a - <br />Michael Is Floral & Gift Michael's Floral & Gif <br />Street Address Street or other Mehing Address <br />115 West 3rd 115 West 3rd <br />City State Zip code City State zip Code <br />Grand Island, NE 68801 Grand Island NE 68801 <br />Pursuant 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 Ne.bm*a Department of Revenue against the above named taxpayer, is terminated, partially released, or subordi- <br />nated to the extent indicated below. <br />TYPE OF ACTION <br />TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. <br />PARTIAL RELEASE. The State Tax Lien is partially released as follows. <br />- Name of party making request ano resport Sible for filing certificate of partial release with appropriate tiling officer. <br />SUBORDINATION. The State Tax Lien is subordinated as follows. <br />Name of party making requeat and reWonsibie for filing certificate of subordination with appropriate filing officer. <br />I hereby certify that Inc Nebraska Department of Revenue has compiled •aith the revenue laws of the State of Nebraska In the <br />determination of -he terminatton, partial release or subordination Indicated above. <br />