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Nebraska Identification Number 36506796 FederalldentlHcation Number Social Security Number XXX - XX - 0120 Spouse's Social Security Number Lien Serial Number 11676857 Lien filed with Register of Deeds Date of Lien 09/02/2016 Tax Category 22 County HALL I BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS DEBRA WARREN 2623 SUNNY BROOK PL • GRAND ISLAND NE 68801 Type of Action D Nov. 21. 2016 2:57PM NE Secretary of State - UCC Pursuant to the revenue laws of the State of Nebraska, notice is hereby given that the State Tax Lien which has been duly tiled by the Nebraska Department of Revenue against the below -named taxpayer, is terminated, partially released, or subordinated to the extent indicated below. El TERMINATION OF TAX LIEN. The State TaX Uen is hereby fully terminated. TAX YEARS 2011, 2012, 2013 (corporate, individual income, and withholding talc only) El PARTIAL RELEASE. The State Tax Lien Is partially released as follows_ TAX YEARS (corporate, Individual income, and withholding tax only) 0 SUBORDINATION. The State Tax Lien is subordinated as follows. sign here reby certify at - - . she Department o ` evenue - s com' w t revenue awe of the determination of the termination, partial release, or subordination indicated above. ka ®em rimerd State Tax Lien Statement of Termination or RE1ii�E#'11�JE me..�e.. Certificate of Partial Release or �ww•,rwar.,.rd. Subordination Revenue Agent The Revenue Supervisor Title 11/17/2016 Date 2 0 161)37 8 2. NE 5sc of 51•to Jahn A o.la - LICE T0I 8936782 -3 Pea: I WARREN DEBRA Filed. 11/2112m1e 11113 AM PLEASE DO NOT WRITE IN THIS SPACE UCC Instrument Num 9 916779931 County Instrument Number 201605853 Continuance: UCC Instrument Number Continuance: County Instrument Number UCC Instrument Number County Instrument Number UCC Instrument Number County Instrument Number (402)471 - 5712 Telephone Number 11/17/2016 Date 4.292.ee Rev. BM Supersedes 4-292 ra Rev. 11e-t6 $su