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Nebraska Identification Number <br />47900709 <br />Federal Identification Number <br />Social Security .Number <br />XXX - XX - 7121 <br />Spouse's Social Security Number <br />Lien Serial Number <br />11681305 <br />Lien Filed With Register of Deeds <br />Date of Lien <br />11/28/2016 <br />Tax Category <br />22 <br />County <br />HALL. <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />JUAN C CHACON <br />222 RHODE ISLAND AVE <br />HASTINGS NE 68901 <br />Jul. 11. 2017 1:28PM' <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 />E( TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. <br />TAX YEARS 2009, 2010, 2011, 2012 <br />(corporate, individual income, and withholding tax only) <br />PARTIAL RELEASE. <br />TAX YEARS <br />(corporate, Individual Income, and withholding tax only) <br />El SUBORDINATION. <br />sign <br />here <br />I hereby certify th <br />del j (nation of th. <br />/ a <br />do r . <br />Apr <br />V'eb„Y,apsirn•b , State Tax Lien Statement of Termination or <br />rit <br />REVENUE Certificate of Partial Release or <br />Subordination <br />Type of Action <br />The State Tax Lien Is partially released as follows: <br />The State Tax Lien is subordinated as follows. <br />Preparer's Slgna <br />uthorized Signatur Tide <br />2017 4620 <br />PLEASE DO NOT WRITE IN THIS SPACE <br />UCC Instrument Number 99167833292 <br />County Instrument Number 201608022 <br />Continuance; UCC Instrument Number <br />Continuance: County Instrument Number <br />UCC Instrument Number <br />County Instrument Number <br />UCC Instrument Number <br />Cnuntginstcumaoflgumbor <br />No. 4069 P. <br />the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in <br />ermination, partial release, or subordination Indicated above. <br />Revenue Agent 07/06/2017 <br />Title Date <br />Revenue Supervisor <br />NE Sec of 5 {a {C John A G.10 - UCC T09 <br />9917794785 -3 Pus <br />CHAGON JUAN C <br />Filed: 07/11/2017 10:42 AID <br />(402)471 5789 <br />Telephone Number <br />07/06/2017 <br />Date <br />4. 232 -68 Rev. 8 -98 Superseder 4- 232 -89 Rev. 10 -95 <br />