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<br /> :� � State Tax Lien Statement of Termination � ;:::=
<br /> �� or Certiflcate of Partiai Release or .�� ���`�-
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<br /> Subordinatlon ��_=
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<br /> � PLEASE DO NOT WFIITE IN THIS SPACE �'�"'
<br /> � °` Puisuent to the revenue laws oP ttie Stefe oP Nebraska,nodce Is hereby ��'��
<br /> �� ��`,�� s� given thatlhe State TAx Uen wdk6 ti�s bcea duly tiled by the Nebraska
<br /> ' Department of Reveaue ugs+inst the below-nurmed tnxpayer�is terminated, _
<br /> parttaUy released,or subordinute�l to the exteat indirated below. .�:-'�
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<br /> „ Nebraekn IdaroEcatlai Number Tex Category Soaal SecuritY ot federal I.D.Number &pouso'S Sociel5ecu�lY Number =--
<br /> � 27861.226 22 508-68-0563 9�6-74-6656
<br /> ::?: I. �w,sada�eunnear uen Fliea wN� oate a uen �ZY --
<br /> — 952230A39 �RBe���otoeeos ❑Caxnyc�er� 02-18-97 HALL
<br /> BL/SINES9 NAME AND LOCA710N ADCiiHSS TAXPAYHR NAI�iB AND MAIUNf3 ADpRE-1
<br /> HualMtf Nam1 N� w
<br /> " . GORDON W & JENNIFER E KOSMICKI
<br /> ':••�.'`'`,�;•�"' steeta oth�r M+w+D naara.a
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<br />-•'�'•'?'%``.':. 1112 EAST PHOENIX
<br />;:�:'�: �y sua tia wos aqr suc. aa c°°'
<br />'°-���°�+' GRAND ISLAND NE 68801
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<br /> _'w,R:..c•:,� 7YPE OF AGT10N
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<br />-_:,:_:irsn (�TERMINATION OF TAX UEN. 'Rie Steto Tax Llen is hereby fuily tcrtninatcd.
<br /> ����'�"�•� 95-1�7205 1992
<br /> �„�z�;,� INSTii9�lENT NUMBER TAX Y�ARS(corpont��nd IrtdtvlduN incom�Ux only) �
<br /> .:��'�i��i � -
<br /> ❑PARTIAL iiEI.EASE. '[he State Tax I.ten Is panially released as foUows.
<br /> - _� INSTFIUNENT NUMBER TAK YEAPIS(corporat�e�fd Indtvidud Incom�t�x only)
<br /> �-i?���-��a� �SUBOADlNATiQN. 'I1�e State Tnx Lten is suhordineted as follows. `
<br /> "'``��'"� INS7'HU�IAENT NUMBER
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<br /> - - .,'�:" Nams of panymakYy reqvest arb responSiW�tor fiung cerofieato of putlal release w suborOkiatlOn wltli epproprute Ning officer.
<br /> . . I hereDy Cettify that the Neixasku DepaRment ol Revenue hae complied with the revenua laws of the Stete ot Nebraska h the tletorrtMnatlon o1 the �.-
<br /> termretion,p�rtlal rebase.a euborainatbn�ndkatea ebove.
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<br /> NEBRASIW DEPARTMEN7 O NUE•Whlte 8nd Canary Coples TAXPAYER-PMk COpy COUNTY OFFICE-f3ddenrod Copy
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