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Pursuant to the revenue laws of the State of Nebraska, the <br />Tax Commissioner hereby gives notice that the State Tax Lien <br />against the taxpayer identified below, the original notice of which <br />was duly filed of record as indicated, is continued, terminated, <br />partially released, or subordinated, to the extent indicated below. <br />Please Do Not Write In This Space <br />. <br />Nebraska ID Number <br />11491094 <br />Federal ID Null er <br />Social Security Number <br />XXX -XX -2249 <br />Spouse's Social Security Number <br />Lien Serial Number <br />11593233 <br />Lien Fled With <br />Secretary of State, Register of Deeds <br />Dale or Lien <br />06/23/1015 <br />Tax Program <br />1 <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />046 <br />Oct, 2. 2017 3:05P <br />Nebraska Department of <br />REVENUE <br />Tex Years 2012, 2013 <br />UCC Instrument Number 99157569807 <br />Type of Action <br />1 <br />® Termination of Tax The -Statc Tax Lien'is hereby fully terminated. <br />Lien <br />I hereby certify that the Nebras rlment of Revenue has complied with the laws of the State of Nebraska in determination of the <br />con n. termination. partial r subordination indicated above, <br />&nail • • , ss <br />s Si <br />ronald.despins(l nebraska.gov <br />4/4 /J <br />11,(4hon Y* "Signatu e <br />E Secretary of State — UCC No. 2115 F. 2 <br />201706653 <br />'due <br />JOHN CARRILLO <br />712 ORLEANS DR APT 6 <br />GRAND ISLAND NE 68801 <br />County Instrument Number 201504454 <br />N! imp Yf C4 I. John R Gala - UCC TOO <br />9917799099 -3 Pee: 1 <br />CARRILLO 30HN <br />Filed: 10/02!2017 09:50 AM <br />Revenue Aeent 09/28/7017 (402)471 - 6067 <br />Dale Phone Number <br />1 <br />State Tax Lien — Statement of Continuation or <br />Termination; Certificate of Partial Release <br />or Subordination <br />venue Senior A¢ent o . / 7 <br />Title Date 4.222.1eee Abu 1 -2015 <br />Supersedes 4-292 -1966 Rev. 6.2014 <br />