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201701899
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3/28/2017 3:50:58 PM
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3/28/2017 3:50:57 PM
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201701899
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Nebraska Identification Number <br />38178613 <br />Federal Identification Number <br />Social Security Number <br />XXX - XX - 6354 <br />Spouse's Social Security Number <br />Lien Serial Number <br />Date of Lien <br />Tax Category <br />County <br />11676928 <br />Lien fled with Register of beady; <br />09/06/2016 <br />22 <br />HALL <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />ROSA M ZAVALA- GARCIA <br />117 VOSS RD <br />GRAND ISLAND NE 68801 <br />• <br />0 <br />Mar, 23. 2117 2:22FM NE 'Secre.tary ,f State - UCC <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />0 PARTIAL RELEASE. The Slate Tax Lien is partially released as fdlalws: <br />TAX YEARS <br />(corporate, individual Income, and withholding tav only) <br />SUBORDINATION. The State Lien is subordinated as follows, <br />d <br />sign r <br />here <br />ized <br />• fat ur / <br />S)gnat rye <br />0 79 <br />NE See of 51 <br />.Se Jahn A Gala - UCC TON <br />9917789395-9 Pas: 1 <br />ZAVPLA-GARCIA ROSA M <br />Filed: 03/28/2017 'MOO AM <br />State Tax Lien Statement of Termination or <br />Nebraek* Elea. rirnbnl yr <br />REVENUE Certificate of Partial Release or <br />wWH.fse. on usr_ /VW <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 filed by the Nebraska <br />Department of Revenue against the below -named taxpayer, is <br />terminated, partially released, or subordinated to the extent indicated <br />below, <br />Subordination <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Type of Action <br />® TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated, <br />TAX YEARS 2014 <br />(corporate, Individual Income, and withholding tax only) Continuance: UCC Instrument Number <br />Continuance! County Instrument Number <br />UCC Instrument Numbe 9916779641 <br />County Instrument Number 201605960 <br />UCC Instrument Number <br />County Instrument Number <br />UCC Instrument Number <br />County Instrument Number <br />raska Department of Revenue has Complied with the revenue laws of the State of Nebraska in <br />tion, partjbI release, or subordination indicated above. <br />Revenue Agent 03/23/2017 (308)632 <br />Title Dale Telephone Number <br />Revenue Supervisor 03/23/2017 <br />Title Date <br />1.2 ]2$0 Rev. MI5 SNyeri94964 32.65 Rev, 1495 <br />
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