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<br />IriFeb,a",a <br />department <br />of revenue <br />Usn Serlal Number <br /> <br />I <br />Notice of State Tax Lien <br />Discharge, Release, or Subordination <br /> <br />. Read instruction, on rev.,.,ide <br /> <br />Release Serial Number Date of Lien <br /> <br />Social Security Number <br /> <br />r <br /> <br />3 09 972 <br />Nebraska 1.0. Number <br /> <br />7123 <br /> <br />9-9-83 <br /> <br />507-38-7028 <br />Spouse's Social Security <br />Number <br /> <br />84- <br /> <br />003696 <br /> <br />3349438 <br /> <br />Usn Flied With <br />[i?J Register of Deeds <br />County.Clerk <br />BUSINESS NAME AND LOCATION ADDRESS <br /> <br />County <br /> <br />Hall <br /> <br />NE <br /> <br /> <br />TAXPAYER NAME AND MAILING ADDRESS <br /> <br />Business Name <br />Golden Horseshoe <br />Street Address <br />402 South Hi h Street <br /> <br />Name <br />Ga ro 1 J. Pri ce <br />Street or Other -Malllng Address <br />402 South Hi h Street <br /> <br />City <br />Cairo, <br /> <br />state <br /> <br />NE <br /> <br />Zip Code City <br />68824 Cairo <br /> <br />State <br /> <br />Pursuant to the revenue laws of the State of Nebraska, notice is hereby given that the Notice of State Tax ,Lien <br />which has been duly med against the above named taxpayer. is discharged, partially'released, Or subordinated to the" <br />extent indicated below, <br /> <br />TYPE OF ACTION <br /> <br />l <br /> <br />!Xl DISCHARGE TAX LIEN. The Notice of State Tax Lien is hereby fully discharged, <br />o PARTIAL RELEASE, The Notice of State Tax Lien is released as follows. <br /> <br /> <br />.-l):- <br />'-J <br />>:,:J <br /> <br />o SUBORDINATED, The Notice of State Tax Len is subordinated as follows, <br /> <br /> <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue Jaws-of the State of Nebraska In the deter~ <br />minati n of the discharge, partial release or subordination indicated above. <br /> <br />Special Aqent <br /> <br />7 -10-'84 <br /> <br /> <br />sign <br />here <br /> <br /> <br />Title <br /> <br />Revenue Agent <br /> <br />7.;lO~H4 <br />Date- <br /> <br />Title <br /> <br />Date <br /> <br />FOR COUNTY OFFICIAL'S USE <br /> <br />NEBRASK.A DEPARTMENT OF REVENUE ~ White and Canary Copies <br /> <br />TAXPAYER - Pink Copy <br /> <br />COUNTY OFFICE - Goldenrod Copy <br /> <br />4'232-68 Rev. 1-8) <br />Supersedes 4-232-68 Rev. 5.78 <br /> <br />u <br /> <br />L <br /> <br />~ <br /> <br />I <br />L_ <br />