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nebra:ka <br />~ri~epartmen: <br />~~at revenue <br /> <br />Notice of State Tax Lien <br />Discharge, Release, or Suborstination <br />• Rssd trsttruetiau on ravwse side <br />Lien Ser'el Number A 1 5!+I t f b i Otte ei Len ~ SOCidt SeGUrkty Numbei -- <br />~~~ i~()`~~~~ <br />2L37/152 5368 <br />~ ! 7/23'32 505 5~ 9386 <br />N•br.,k• 1. D. Nursiber ounty <br />y lJn- F 1>d wrtn Spotae's Soctal S•turity <br />t <br />'~ p~~lSSer ~~ n•eer Number <br />2751380 ~ Ha 11 i~J <br />coumr cr•.k I <br />_ <br />f- -- -- ~_ <br />_ <br />- -- - -- ------ --..--- <br />k _ BUSINESS NAME AND LOCA TlDN ADDNE55 TAXPAYER NAME AND MAILING ADDRESS <br /> <br />Btt,in eri Name <br />Safari Sar g Loun~ <br /> <br />~ _ <br />Name <br />'~erlie <br />G Johnston <br /> <br />svaet naares+ <br />- _ <br />_-_________ <br />scree o+ otne< nrinn3 aearess <br />106 Eas_t_3rd Street_~ _ 803 shady ren~_POad ___ _____ __ <br />CrtY gate Rio Coee - Ctty Stacy zip Cooe <br />Grand Island, _ "lE __' fi88Q1 Grand Island- _---'V_E _ ___ 683101 <br />Wrsuartt to the revenue taws of the State of Nebraska: ho6ce is hereby eiren that the Notice of State 'f ax Lien <br />which has been. duly' filed againstthe above ttarned#axpayer, is discharged, partially released, or stbordinated to the <br />extent ittdicated below, <br />~_ TYPE OFACTION -~-- __-. --_-- __`. _-~ <br />Op DISCHARGETAX UEN. The NMtce of State Tax Lien ishereby fully discharged. <br />:.J PARTIAL RELEASE. TheTioticz af.State Tax Gen is released as foliaws. <br />^ SU6ORDINATFD. The lvotice of State Tax Lien is subordinated as foitows. <br />n• <br />r•trY cvtirY In.t In• N•MtlM. O•fgrtm-rlF^r R•wnue hsz cRmo'•.Q w11n tn•.eve! t+a law t~ Inc Sta[u o ~eUrasa ~ [hH Unter- ~~~_- <br />n norm ~c n. q.~, par ~ sun.,+u n.r.oo ~ a o ea abwn. <br />~-u- ~ BeStEtILLP_1~gP n t <br />._ ___-___.--_.__ _=1-~.~-_ <br />M~r~ p...,., atir. -,;r,: oa:F <br />`_; <br />_. <br />FAgmoa..e •mr. ,.~.a4~~---~_ T;a~.~e~lt~f~n~__ -- `a-J~i2_ <br />~a:e <br />-- -- ---- ---------------------- <br />fOp COUNTY OFFICIAL'S lKE <br />.aEP 'r'~2 ~• <br />/~ <br />~~..-a - _ <br />_ -,. <br />i;te>c~ <br />.~~~: ,_ <br />NEBRASKA DEP aRTMENT OF REVENUE- Whin end Camarti Comes TAXPAYER - P,nk Copy COUNTY OFFICE -Goldenrod Copy <br />~--- ~- <br />~_.__ <br />I <br />_~ <br />