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Notice of State Tax Lien <br />neb aska Discharge, Release, or Subordination <br />rrpartment ~ Read itit,uetions on revraa aide <br />Lien Serlai Number Release Serial Nu~ber D~te of Llen boclal SecurltY Number <br />'/St ~~~ 0 9 5 2 <br />2/03/765 6878 '3-24-82 505-56-5898 <br />Nebraska I.D. Number County tJen Flletl Wlth Spouse's SOtlal Security <br /> ® Register of Deetls Number <br />2780062 Hall cppntvclerk <br />City State Zip Code city State ZIp.GOna- <br />Grand Island, "lE 68801 Grand Island, ME 6$80.1, <br />Pttrsuant to the revenue laws of the State of Nebraska, notice is hereby given that the Notice o6Sfate Taz Lien,- <br />which has been duly filed against the above named taxpayer, is discharged, partially released, ocsubordinated:to tAe <br />extent indicated below. <br />TYPE OF ACTION <br />[~ DISCHARGE TAX LIEN. The Notice of State Tax Lien is hereby fully discharged. <br />^ PARTIAL RELEASE. The Notice of State Tax Lien is released as follows. - - - <br />^ SUBORDINATED. The Notice of State Tax Lien is subordinated as follows. <br />I Hereby certlty that the Nebraska Department of Revenue has complied with the revenue IawS or the State of Nebraska in the datM-- - <br />mination of the discnarge, partial release or su bortlinatlon Intli cd red above- <br />~ ~ 1 'y~~~J I <br />sign - 9A~-1na,~r~ Vl l~ Revenue I~gent ~~E-,84 <br />hQ[e rdrepuer•s to ~ Hue Date <br />II L _ Special Agent 2-24-84' <br />a n.~en,..~.on cl, .~~.a ~ Title Daia _ <br /> <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Name <br />Michael's Floral R Gift Michael Clark <br />Street Atltlress Street pr Other Mailing Atltlress <br />115 West 3rd 115 West 3rd <br />NEBRASKA DEPARTMENT OF REVENUE - Whde and Canary Copies TAXPAYER -- Pink Copy <br />COUNTY OFFICE -Goldenrod Copy <br />a-232-68 Rev. 1-81 <br />Supersetles 4-232-68 Rev. 5-]8 <br />U <br /> <br />t,..,. <br />