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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 />Nebraska ID Number <br />12135372 <br />Federal ID Number <br />474983449 <br />Soclal Security Number <br />XXX -XX -0682 <br />Spouse's Social Security Number <br />Lien Serial Number <br />11788969 <br />lien Fled With <br />Secretary of State, Register of Deeds <br />Date of Lien <br />06/02/2017 <br />Tax Program <br />1, 67 <br />County <br />HALL <br />I Business Nameand Location Address <br />Taxpayer Name and Mailing Address <br />Jun. 6. 2018 3:15FM NE Secretary of 'State — UCC No.46i8 F. 213 <br />b <br />Nebraska Department of <br />REVENUE <br />Tax Years 2016 <br />UCC Instrument Number <br />® Termination of Tax <br />Lien <br />horized Signature <br />State Tax Lien — Statement of Continuation or <br />Termination; Certificate of Partial Release <br />or Subordination <br />The State Tax Licn is hcrcby fully terminated. <br />Si gnet <br />sandra.Rleason(nebraska.gov <br />Email Ad S <br />�U44 <br />Title <br />Tills <br />NE See • WWe1e Jahn A e.le - NEC re9 <br />IH111111 <br />9918813208 =7 P9s' <br />LA ROSA PEREZ RAMIRO Y <br />Filed 05108/2018 09:38 R14 <br />RAMIRO Y LA ROSA PEREZ <br />1021 WEST LOUI E ST <br />GRAND ISLAND NE 68801 <br />County Instrument Number 201703814 <br />201803609 <br />Type of Action <br />1 hereby certify that the Nebraska Department of Revenue has complied with the laws of the Slate of Nebraska in determination o1 the <br />co Inuatlon, termination, parlisl rglease. or subordination indicated above. <br />Rrvctmt: Senior Agent 05/31/2018 _0021471 -5727 <br />Date Phone Number <br />Revenue Senior Agent <br />Date <br />4.232. Rey 1 -2015 <br />Supersedes 4 - 2321968 Rev. p•2014 <br />A—, <br />