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Mar, 27. 2018 3:07FV1 <br />STATE TAX LIEN a NEBRASKA DEPARTMENT OF LABOR <br />■ TERMINATION <br />NDOL Office of Legal Counsel <br />P.O. Box 94600 <br />Lincoln, NE 68509 -4600 <br />Telephone - (402) 471 -9912 <br />FAX - (402) 471 -9917 <br />X <br />n/a <br />Employer or <br />Liable Person: <br />Address: <br />NDOL Acct. No. <br />Federal ID No. / SSA No.: <br />FULL Termination <br />Date; March 23, 2018 <br />NE Secretary of Stat <br />He A. ltath'en <br />1504 W Ave. Grand Island, NB 68801 <br />0288410005 <br />xxx -xx -0920 <br />This TERMINATION serves to remove the lien described below and the priority of the Nebraska Department of Labor on the <br />affected property of this employer or person. This Termination is filed pursuant to Neb. Rev. Stat. § §48 -657, 48- 660.01, 48 -664, <br />and the Uniform State Tax Lien Registration & Enforcement Act (Neb. Rev. Stat. §77 -3901, et seq.). <br />Property description (ONLY if PARTIAL Release): <br />LIEN TO BE TERMINATED: <br />PARTIAL Release' <br />I certify that the Nebraska Department of Labor has complied with the Employment Security Law of the State of Nebraska <br />in the determination of the amount due, and the employer or person has failed to pay the amount due after demand. <br />By: <br />L. \Gcncral <br />Co nscl\ LcgeADOCUMENTS \FORMS\Liens \Termmation.docx <br />RETURN FILED COPIES TO Nebr. Dept. of Labor - LEGAL <br />P.O. Her 94600 <br />201801906 <br />NDOL Serial No. : <br />County: <br />JOHN H. ALBIN <br />Commissioner of Labor <br />Hall <br />- NE See $4Mke John, A Gals - Utc <br />11111 1111 <br />9918808170 -9 P9s: <br />RATHJEN HENRY A. <br />Filed: 03/27/2019 09:37 AM <br />LA.B -0017 -2018 <br />State Tax Lien Document No_ : 9918807277 -4 <br />County Document Filing No.: 0818001408 <br />Other Filing Information: Orig_ Filed Co. March 7, 2018 <br />@ 4:30 # 201801408 <br />KATIE S. IitJRBER, Agency General Counsel <br />THOMAS A. UKTNS1 T, Legal Counsel <br />LIBBY K ELDER, Legal Counsel <br />- - - No. 0264 F. 4 <br />TVS <br />NEBR DEPT. OF LABOR <br />CHARGE ACCT. #1474 <br />