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-a.R <br /> C �fl <br /> �: <br /> �\� �. � � - _-' ._:-..� . <br /> �, \ � I ;� =� : . �� <br /> „a =� ar� <br /> �,� c� � T� � :y <br /> �� � , � a <br /> � -r� y i,._a ;y <br /> '� ;I'� <br /> \�' .1 S 1'TI '� <br /> � � ' , i J ^\ 2=n �-- G, � <br /> �\ 1�� :/\�O =L 1^-Y �� �; <br /> ,� G . � �(` .�� f; �.27 <br /> , � ,.j • .h '�•.., '_' � 3 <br /> � � _ -�J �v <br /> a� K �'�� - `...... � � <br /> � �� �{ "'�' �G j O <br /> C` t <br /> �• \` <br /> � � State Tax Lien Statement of Termination <br /> �� �r or Certificate of Partial Release or <br /> � M�� Subordination � <br /> d�pffbllMt <br /> O�fWMIW <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 81ed by the Nebraska <br /> Department of Revenue against the below-named taxpayer,is terminated, <br /> partially released,or subordinated to the extent indicated below. <br /> Nebraska Identification Number Tax Category Social Security or Federal l.D.Number Spouse's Social Security Number <br /> 38556421 22 262-61-6850 <br /> Lien Serial Number Lien Filed With Date of Lien ��� <br /> 9 5 2 510 0 0 6 �Register of Deeds ❑county c�erk p g_0 8—9 5 HA <br /> BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br /> Business Name Name <br /> Y W <br /> Street Address Street or OMer Mailing Address <br /> City <br /> State Zip Code Ci1y State Zip Code <br /> TYPE OF ACTION <br /> [�TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. INSTRUMENT NUMBER 9 S—tn7h53_— <br /> TAX YEARS (corporate, individual income, and wfthholding tax only) 19 9 4 <br /> ❑PARTIAL RELEASE. The State Tax Lien is partially released as follows. INSTRUMENT NUMBER <br /> TAX YEARS (corporate, individual income, and withholding tax only) <br /> ❑SUBORDINATION. The State Tax Lien is subordinated as follows. INSTRUMENT NUMBER <br /> Name of party making request and responsible for filing certiticate of partial release or subordination with appropriate filing officer. <br /> I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in the determination of the <br /> termina' n, artial release, r subordination indicated above. <br /> sign /3, � �����s-!� <br /> here ��arer'sSignatu e itle / Date TelephoneNo. <br /> R, % /�{,,,,�, V � ,s�% 3 ./ '--�— <br /> � 14u1horiz ig re Title te <br /> NEBRASKA DEPARTM NT OF REVENUE-White and Canary Copies TAXPAYER-Pink Copy COUNTY OFFICE-Goldenrod Copy <br /> 4232•68 Rev.9-96 Supersedea 4•232-68 Rev.10-95 <br /> I <br />