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1 <br />State Tare Lien <br />Stat _ nt of Tenrrination or <br />C01,M164to of P to 10 440 Subordnation <br />Lion' Soulat Numtae+ ttiacutna+aS $or Nt mate of Lien Social security Number or <br />Number Federal I.Q. Number <br />5/101 11000 1 -2 -855 }pt p+� <br />Nebraska 1,0. hlcsm rr jeoH.11 unty - n Flied With Spouse's Social Security 8 - - 1049.2.E 1 <br />Register of Qeadt Number w� Y <br />3M . County Clark <br />N LOCATION ADCH93111 TAXPAYER NAME AMC MAILING ADDRESS <br />ousum,o No"" Name <br />Ids. Jas ftg Care Inc. Mrs. Jans Dav Care Center Inc. <br />street Address Street or other Mailing Addron <br />41S West Oth <br />efty' - State Yip Cade City State .Zip Cube <br />Grand Island, H 68801 Island, NE 68801 <br />Funiumat to the raverme bras of the Sate of Netimalia. Notice is hereby given that the State Tax Lien whkh has begin 4* <br />Mail by the of Reverme aproaft the above clamed taxpayer, is terminated, partially lideaved, or <br />to the extent indicated below. <br />TYPE OF ACTION <br />E3 TERMINATION OF TAX LIEN. The State Tax Lien is hereby 9uth terminated. <br />C1 PARTIAL RELEASE. The State Tax Lien is partially released as follows. <br />Name of party making request and resPOnslbla far riling certificate of partiaz release with approprlatC !sung officer, <br />M StiNORDINATION. The State Tax Lien is subordinated as follows. <br />Party maktrag; and responsible for firing certificate of suboroination with apmaoilate tieing officer. <br />, hereby certify that the Nebraska Department of Revenue has complied with the rtvinua taws of the State of Nebraska In the <br />faran0n at the tetmthatl \ap. partlat release or su /bordmation Indicated allow*. <br />'11#1EGRASKA DMAFITMENT OF REVENUE - White and CanarY Copies TAXPAYER - Pink Copy COUNTY OFFICE - Gotdanrod Copy <br />4. 232 -66 Rea. 5.86 <br />Suoerse4as 4. 232.66 Rev. 1 -61 <br />