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Apr. 9. 2019 3:27FM NE Secretory _t Stat 2t.1112F029 <br />NRS.cofSul&-nnbcRB. :`,mm <br />Filing Document #: 1904000634-5 Pages: 1 <br />Deblor Name: KAMM:NE L PATTON <br />Piling Date and Time: 04/09/2019 10:45 AM <br />STATE TAX LIEN • NEIIRASKA DEPARTMENT OP LABOR <br />■ TERMINATION <br />NDOL General Counsel <br />P.O. Hos 94600 <br />Lincoln, NE 685094600 <br />Telephone - (402) 47t-9912 <br />FAX -(402) 471-9917 <br />Employer or <br />µ <br />Liab)e Person:_ Katherine 1...Patu n <br />Address; V 1004 N. (icddeGrand Island. Nl 68801 <br />NDOL Md. No.: 0321290003 <br />Federal ID No. / SSA No.: xxx-xx-1123 I <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 A'eb. Rehr. Stai. §§43-67, 4S-660.01, 48-664, <br />and the Uniform State Tax Lien Regitiration & Enforcement Act (Neb. Rer. Siai. §77-3901, el seep). <br />LIEN TO BE TERMINATED: <br />X FULL Termination PARTIAL Release <br />Property description (ON/. lif PARTIAL Release): <br />n/a <br />NDOL Serial No.: LAD -0259-2013 <br />Stale Tex Lien Document No. ; 99 13 721 16 8-0 <br />• <br />---------- <br />County Document Filing Na.: 2013-06708 <br />Other Filing Information_ STL filed 8!1912013 <br />I I:02am; Hall Co. filed 8119.2013 {ate 3:51 pm <br />I certify that the Nebraska Department of Labor has complied with the Employment Security Law alba Stale of Nebraska <br />in the determination of the amount due, and the employer or person Inas failed to pay the amount due after demand. <br />Ilett: August a, 2019 fy: <br />L:4C1eoeral Ctmellel‘LegaRDOCUMENTStStoitc Ts: I.icniUta1c <br />lax LiensA3 20000 000I03 21290 003 OB -1 9-2013 Ism <br />(Pnilee) loc' <br />JOHN H. ALBIN <br />Commissioner of Labor <br />KATIE. 5. THURBER, General Counsel <br />LIBISY K. ELDER, Legal Counsel <br />JARROD S. DOT'fNOTt, Legal Counsel <br />RETURN FII.FI) COPIES TO: Nebr- Dept of Iabnr- LEGAL <br />Y.U. Boa 94600 <br />[Jacobi. NE 60509-4600 <br />NEBR. DEPT_ OF LABOR <br />CHARGE ACCT. #14765 <br />