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IWSTRUC7tONS <br />- _ PURPOSE OF FORM, This form a an he ::sed by the ~ehraska <br />- Departrnent of Raven ue for tha pn?pose ~f rotityinS he enpropriate <br />#.-- ~ _ caurty authurfties chat tha Nebraska tiotice of Scare T~xL,ien on ila <br />-,. - ' ` i ` ~ ~ in their r;'fice is bzing discharged. partialky relessed irr subordinated. <br />as cam ~ rrt <br />CJ 6 -a 1 ~ fM ~ <br />C b a' W <br />m C' ~O i ~Ql- <br />ca q o ~ <br />- - . ~~~(~~ O ft ~ '~ 2 _ ~n ~ <br />c ~ t ~, <br />nt 0 ~ r- q ~ --~ <br />~ N ~v ~ ,~ <br />w ~, <br />~°~ W <br />~~ ~ <br />f <br />~ ~ <br /> <br />