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NEB. AS44A <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 1911000422-2 Pages: 1 <br />Debtor Name: ANDREW D WERTZ <br />Filing Date and Time: 11/08/2019 09:58 AM <br />201907057 <br />State Tax Lien — Statement of Continuation or <br />Termination; Certificate of Partial Release <br />or Subordination <br />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 />Netensaa 10 Numbs.' Federal ID Nu -Ater E Social Seeorey <br />41165683 3 XXX -XX -3365 <br />Liens Senat Number ten Meet Date: et Lien tar t tr,gram Coo: <br />11438759 08/22/2014 22 HALL <br />Business Name and Location Address Taxpayer Name and Mailing Address <br />Please Do Not Write In This Space <br />N a^ <br />Secretary of Stair, Rr ister of Derd,,, <br />ANDREW D WERTZ <br />1041 S LOCUST STREET <br />GRAND ISLAND NE 68801 <br />lax Years 2011 <br />'CC Instrument Number 991474€)9376 <br />County Instrument dumber 201405252 <br />Tt•rmituliota or lax <br />lien <br />Type of Action <br />lite State lax Lien is hereby fully terminated. <br />I hereby certt/ that tre Netxasia Dopa,lmr rn u!. tikxr;rnao has eompaie <br />tura+. ta,rni',at en. part al rotoase. Or nutxxdirmti,r, reli,atee au <br />$ <br />brandrtn hrt?wIlfencbraska gov <br />Fined Address ,.. <br />RevenucSSnior Arent <br />ride <br />a212•t96a Per. A.106 <br />5+4.o+indlea. a 53 ,BOA Rev. 14014 <br />