|
_ _ . .` :�.:t. , r _ __
<br /> 1 ; k 'f
<br /> �X{ 4 ac� } ..e T._.Y.-.�.. �. �c.^.,r� . .:_ ' ^c- '•�C � �� 1 ��T sy;• _,,.___
<br /> .�' �. -_} .�` ,�, y-... ' ' - .' _ _�.-.- ) c `..s�_ _.c--._.�"" .�- - - �- -. ..
<br /> -;-1r- -����.ar�_t��
<br /> -e,-� _,. .. _� . . ,-c- - �- � '' - ,ne�-
<br /> - _`�.�'4 ,�'Y— —4�- '4 - -- A l ` , . . s i� ^Y.-�Y'ik�s=�-
<br /> ,._��. -'� c.-. . . . _`�.�-�-�.��r . �-� }*��'�ie,�c..--_
<br /> _ . .,
<br /> -.. .. . .
<br /> �, ,.` - - - �-- --
<br /> .:4� � . � ! . < ' -=.. . . -. . . -t i. '- .. � � ` ' ... . ' . _. ..
<br /> ,, . . .��� � �����`�. t.�� ., � , ,•.��, �'�'_ .
<br /> }� . ' • � ' •� ?� . I�� TAA -, - � �. . ,s' �tr-_.L���.��
<br /> � . . . . . . . _ . �E x A}t_.
<br /> -...�� .,-'.�'�• .iW ����1�lYY!- ■Yw�.. �`. _ . . ., .. . . : '.• , - ,�',c`-- `-� �.
<br /> ', �CC01M«�s REFER;TQ ?NESE:IlUlI�ERS `. � ���� i7�„` . " `,
<br /> ' , � < - . _ - , . . . � r, .
<br /> : � . . . .. . . ,
<br /> ..� . . , .. t.� a��y ��}���+r . . .
<br /> . .. .:.. : `._ . y��� . .. . ! - - - - - - -
<br /> � � �.r-•�f�-�'-i�is-,--_.---:-':�J���7?t�i���-`--=---'-�--Kif-l-l-��-fM4v!i4MR-'�-�`-- -_--�-'--.---- ---. - ---
<br /> . . . � �! ��� �!!� s!A!Y� y�' i�� •' , � ,c: . .. . . . .- Y y ..
<br /> � ,' i��iYr�- K�S '��Y! . c . � . ° 1YF� w, �� i� , . . . c . .
<br /> t�#ur� �Y� . � . � �9�t � a�a�croRT . � . � rw:�4r1�, �`. �.
<br /> � tiEN Mp. . ` l�T�Ot4 . � . � � � < `- �. � . .
<br /> -. � Ltbl #E�E l�0• - . . �21fi22�T .. � _ . � _ ` � _: . . `
<br /> ;
<br /> , ,C� � , . .. � : ` . � . ` � . .
<br /> ' OAT! i�! IIQTICE . ,�/3i1�32 . . ,
<br /> �, , . . , , .
<br /> ,IMiTRf�fi�llT 110� ' _ .�1r�0�••� ,. � � • ` � . .. . .
<br /> � �. l�iYAMT �TO TME �R�r�EN{� LAIiS 0� TNE StA�E.OF NEBR�31fAt !(OTICE� IS . __-
<br /> l�RHY-iIMEM iY ZME IiEiRAi1fA DE�ARTMEM7.�OF REYENUE xf1AT� TNE
<br /> ' �TATE tA�4 I.I�K NMYCN MAS �EM ONLY l�x1.ED Af:AIti�T �liE A�t111E MAME� _ � .
<br /> ,� T+�AyER l�0� IMDI1tIDU�L INCC1�lE TA�(�� -3S �TEftpIMATEO. . � _ . . ,
<br /> , I MERE�Y.�C�RTI�Y T1U1T TME NEBR�SKA� DEPAR'�MEMT OF AEYEMliE NAS EG!l�LIED` _ . _ _
<br /> -- ;. MITl� TME lt�YE I�JE LANS OF 1N� STATE CF N�BRASKA IM TNE�DETEKI�IIMATIOIi QF �
<br /> TNIS TERMItiATIQN• ' _ , , .
<br /> ._ � . _ _ .. _ s- .. . - .-. ' ` . ..... � ..�.�..`d.�.+J.l.:ar ' � —
<br /> � • •
<br /> pARER�S SICNATURE � . ��f� � . •
<br /> r.r'� 4
<br /> — ��• • ♦����• � •�• �* •��i i•• •�i•i•!•i/i����i .
<br /> -= AUTIiO ED SZCMATURE ��7LE � DATE �
<br />�-�� .. .. • _ �
<br />;�.• , '
<br />_ � � . FDR COUNTY OFFIC3AL�S US�^ N �'� � � �_-
<br /> � ��' � � �� � --
<br />' ;.�� � ��. ,� �� � . Q• ,
<br /> '4� � 0 '
<br /> �� �!`.
<br /> . � , , , �. ' �V �_ �� {� �!.i.
<br /> t.
<br /> ` ' �� T.1t1 N ��
<br /> �\ � °� � x'm � ='j ";.
<br />-`:.,;,: , a1� . , . •� a � r � . U1 .���°., -.
<br /> _ :,;.:j. 7 � tn � .� „
<br /> �.r. . . . -l� . it ;� - -
<br /> .t�:.:. ., � , ¢ . ..
<br /> - ' p vv � � '�
<br /> i., t . . _ . "� � . � � �`..�,:�:
<br />",.Fi.s - . � n'
<br /> y.-
<br />?i7��:;j .. �¢ . " , .. . .
<br /> ��'1�.� ` . . . ' .
<br />- ..�(. � . • � . . • - .
<br />- . � �,.. - ' ' . , ' �
<br /> .�.�. , � � � • � � � �.
<br /> ,.;. ;:. �
<br /> t_ �.
<br /> , �� ��+_.• . �
<br /> ��� ' NEBRASI(A DEPARTMEN7 OF qEVENUE—White and Canary Copias tAXPAYER—Pink Copy COUNIV—Do!denrod Copy `
<br /> - �' �.us��ari.s�, f
<br /> S�; � Supatse:l.�7•taS79 R.w.5�� E �
<br />- , }
<br /> -- _ !
<br /> �. � . �
<br /> .
<br /> ' r �--� _. _ . .. . . ,. . ... �. .__•-�..---�---r- .. -- _ .
<br /> ' f'• ,. 2Y11I.lZ:e:�11I�.'.'a��t� .. -.� �._ --...._-� . � .. ' • � ] . � ' � . ..
<br />�- ' � '�' ,. �. ' ,• • 1 . ', '�I ' � . ' ., • • � ' 1
<br /> . _ . ..��.......L... . . . '- . � . ' . . . . � . . .
<br />. . . . ' . ..'�i.�rF".p ' . . ' . .. • .
<br /> ' �.�v1'� J�.... .' • . . . . . � . . . .
<br /> _J:_.—__. . . . .. /j1
<br />. ..... . � .:. . . ." '_ "
<br /> " . -' - tJ•.� ' _ � _ ._ ' '_ ._'. . . . . _. _ . . . ,.. ." _ " . _ '" . " _ ' '
<br /> s���. ... . . . � � . . . • . .�� � � . " .
<br /> ' . �`� y. . . . . . . . ' . . . . � . .
<br /> . r1r2�9, E�.��. �. . ' ' . . � � . ' ' . � _ . � . �. , .
<br /> +L +'���=1�;1 ' . . . . . . . .
<br /> 't�. .• � � � . . � f ' r ..• .. I. • • .
<br /> .. .__..'. � .. . ...._ ... . ...___ �_ ..... ._'— '"'_ "___ -- - _ _ _ _ _ - _z - " _ _ - ..
<br /> --__ _-_ —..__- . _ _ • ._�,. . . .. .. .
<br /> �:'r�- � :.� C � . __. '_' '_"_ —_'_ . '_— ___. ____"_ _. . . . " . .. -.,— ' —. _._—. .. __ _ : __ .
<br /> � �f.L:.,��4....1_ J' � . 4 . , . , • -_ '. . .
<br /> . .i+iC".T•':�'�.�r�.. . . � .. . ' . . - . . t. . .
<br /> �.• . _ . . ' 1 . . . . . , . ' ' ..
<br /> � :.._"I"i� .. . -� � � . • ... ' . . . ' . '' . .. � . � . . - . .[
<br /> `'� , . , ' . � ' . . „ . _ " ". . . ,` . . : . ." ' � .• �"
<br /> . .. . � . . . • .,�.y:� .. . . . . . � , .. . i . ' .__ . _..�.�. . ___ �14�..,� �. ..- . __- ._
<br />
|