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Jan, 23. 2019 4:37PM NE Secretary of State <br />20190048k <br />No, 1679 F. 2 <br />ifE Sec of State Robert H. Dunn <br />Filing Document #:1901001628-4 Pages: I <br />1)drnr Nems fDAAD H I118S1 <br />Faint Date and Time( 012)12019 01:48 PM <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />,;,,,,�✓;, State Tax Lien Statement of Termination or <br />REVENUE Certificate of Partial Release or <br />Subordination <br />Puisuanito the revenue laws <br />given that the Stale Tax Lien <br />Department of Revenue against <br />terminated, partially released( <br />below. <br />of the Slate of Nebraska, notice Is hereby <br />Which has been duly filed by the Nebraska <br />the below -named taxpayer, is <br />or subordinated to the extant Indicated <br />PLEASE 00 NOT WRITE IN THIS SPACE <br />—Spouse's <br />Neeoaslm Iderttificalion Number <br />96102087 <br />Federal Nim l$8canon Number <br />Social Security Nurrter <br />XXX -XX -9191 <br />Social Security Number <br />Lien Senol Number <br />11550140 <br />Uen IOW with Register of Deeds <br />Date of Lien <br />04/17/2015 <br />Tax Category <br />• 22 <br />County <br />HALL <br />BUSINESS Wale AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />FUAAD H HIRSI <br />2608 CHANTICLEER ST APT F <br />GRAND ISLAND N. 68801 <br />Type of Action <br />El TERMINATION OF TAX LIEN. The Stale Tax Lien is ht'eby fufyterrldhaled. <br />Tot YtAps 2009 - <br />(corporate, Individual intorno, and withholding las only) <br />UCC Instrument Number 901 57 526 51 g <br />C011nty.fniWm*nl Number 201502477 <br />Continuance: UCC Instrument Number <br />Continuance! County instrument Number <br />❑ PARTIAL RELEA8E. The Stele Tax Lien is partially released as totems: <br />TAX TEARS <br />(wrporete, Individual Income, and withholding Lu only) <br />UCC Instrument Number <br />County Instrument Number <br />0 SUBORDINATION. The State Tax Lien is subordinated as follows. <br />UCC 'mire/nom Number <br />County Instrument Numbcr <br />sign <br />here <br />I he , • cart' I al a t . `eveere as Iomp"' w. I reaglua ow%0' - We ol Nebraska <br />dateriitlnadcn of the tereinagen, partial rause. or 50bOrdlnation Indicated shame. <br />Revenue Agent 01/17/2019 (308)632-1203 <br />TMe Gate <br />Revenue SupervTile <br />isor <br />Talepnone NrmOer <br />01/17/2019 <br />Dale <br />..132.0n Rev I -u u erxaes r)) -ea 9e+. IMO <br />