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� � � <br /> \.� <br /> � � � � �, c� �..—,;�. <br /> � 6:-,� --�� �e � :'� '°� � � <br /> � � :� � .� . , � <br /> �` �" � ;� � �,,� --- ., CO .� <br /> l',"' J �n � -,, `�' �', � �. <br /> -�ca �' '' .� � � �—' � <br /> 4�'�, � . ra ra e�, � <br /> {� � r- :°� ` � <br /> � d � o r :" fV �. <br /> �, -. <br /> � � 3 <br /> -- �--.r- PV c� <br /> „ �,� � �- <br /> 4"•) <br /> � State Tax Lien Statement of Termination o <br /> �Ir <br /> or Certificate of Partial Release or <br /> MEfifka <br /> d'P"°"•^` Subordination ` '� <br /> a►w.��. <br /> PLEASE DO NOT WRITE IN THIS SPACE <br /> Pursuant to the revenue laws of the State of Nebraska,notice is hereby <br /> given that the State Tax Lien which has been duly tiled by the Nebraska <br /> Department of Revenue against the below-named taxpayer,is terminated, <br /> partially released,or subordlnated to the extent indicated below. <br /> Nebraska Identification Number Tax Category Social Security or Federal I.D.Number Spouse's Social Security Number <br /> O1 505-76-9017 <br /> Lien Serial Number Lien Fiied With Date of Lien Cp�my <br /> a��ste�or�as ❑co�r,ey cie� 0 8—0 2—9 6 HALL <br /> BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br /> Business Name Name <br /> A E RIEFLIN <br /> Street Address Street or Other Mailing Address <br /> 11A <br /> GtY State Zp Code CitY State Z.ip Code <br /> 8832 <br /> TYPE OF ACTION <br /> �TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. INSTRUMENT NUMBER 9 6-10 6 0 6 4 <br /> TAX YEARS (corporate, Individual income, and withholding tax only) <br /> ❑PARTIAL RELEASE. The State Tax Lien is partially released as follows. INSTRUMENT NUMBER <br /> TAX YEARS (corporete, Individual income, and wlthholdtng tax only) <br /> ❑SUBORDINATION. The State Tax Lien is subordinated as follows. INSTRUMENT NUMBER <br /> Name of party makirg request and responsible Tor filing certifiqte of partial release or subordination with appropriate filing oificer. <br /> I hereby certity that the Nebraska Departrnent of Revenue has complied with the revenue laws of the State of Nebraska in the determination of the <br /> termination,partial release,or subordination indicated above. <br /> sign ' � c�a�'3 �-��3 <br /> here ��e �gs���fe � �te TelephoneNo. <br /> � ��.��.� �, _.. u s �c <br /> n�mor�Z s re rme te <br /> NEBRASKA DEPARTMENT OF REVENUE-White and Canary Copies TAXPAYER-Pink Copy COUNTY OFFICE-Goldenrod Copy <br /> 4232�68 Rev.&96 Supersedes 4-232-68 Rev.10.95 <br />