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J <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />Gxv l fe Greet rerv. ce. <br />2020016817 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2003000751-8 Pages: 1 <br />Debtor Name DEWAYNE SHORT <br />Filing Date and Time: 03/16/2020 12:10 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 />Please Do Not Write In This Space <br />Nebraska ID Number <br />46653147 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -1025 <br />Spouse's Sodel Security Number <br />Lion Serial Number <br />11044244 <br />Lien Feed With <br />Secretary of State, Register of Deeds <br />Date of Lien <br />07 -SEP -10 <br />Tax Program <br />22 <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />DEWAYNE SHORT <br />PO BOX 150 <br />DONIPHAN NE 68832 <br />Tax Years 20011 <br />UCC Instrument Number 99106369193 <br />County Instrument Number 201006497 <br />Type of Action <br />® Continuation of Tax <br />Lien <br />This is a continuation of an existing lien and serves to continue the lien and priority of the Nebraska Department of Revenue <br />for an additional 10 years. <br />n, <br />Nebras <br />01 Revenue has cortpbed with the tews of the State of Nebraska in determination of the <br />subordination indicated above. <br />Revenue Agent 09 -MAR -20 (3081612-1210 <br />ignature Title Date Phone Number <br />jt�Jtn : mss <br />ebrask .env <br />bri <br />-l-t� <br />nature <br />venue supe <br />4-232-te6e Rev, 0-2010 <br />Supersedes e-232.1900 Rev. 1.2015 <br />