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NESR-A.644A- <br />! <br />0.111441111.114110.110.00.11 <br />202001420 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2003000207-2 Pages: 1 <br />Debtor Name: SCOTT BENNETT <br />Filing Date and Time: 03/03/2020 12:43 PM <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 />Nebraska ID Number <br />99354128 <br />Lien Serial Number <br />11808899 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -3319 <br />Please Do Not Write In This Space <br />Lien Fled With <br />Secretary of State, Register of Deeds <br />Business Name and Location Address <br />Date of Lien <br />22 -JUN -18 <br />Tax Program <br />22 <br />Spouse's Social Security Number <br />XXX -XX -8174 <br />County <br />HALL <br />Tax • . er Name and Mailin • Address <br />SCOTT BENNETT <br />RACIIEL BENNETT <br />501 SOUTH CEDAR STREET <br />GRAND ISLAND NE 68801 <br />Tar Years 2015 <br />UCC instrument Number 99188146327 County Instrument Number 201804125 <br />Type of Action <br />Termination of Tax The State Tax Lien is hereby full) terminated. <br />Lien <br />I hereby certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska in determination of the <br />cxrnteluation, termination, partial release. or sutrweinaaon indicated above. <br />.Cv ,,tF A F-3cr30.rt wlRevenue Agent ''6-FFII-70 <br />Preparor s Signature Tate Date Phone Number <br />5712 <br />chria.dittmar(ynehraeka Lov <br />Email <br />GtsC_.- <br />Izod Signature <br />4-232-l960 Rev. 04010 <br />S.rpersedes 4 232.1966 Rev. 1.2015 <br />