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11111111111111111111111111111110111111 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2004000191-1 Pages: 1 <br />Debtor Name: CHRIS GREEN <br />Filing Date and Time: 04/03/2020 09:25 AM <br />202002057 <br />k.„„,,,a„en d. State Tax Lien Statement of Termination or <br />REVENUE Certificate of Partial Release or <br />��,.,..-.....W✓ Subordination <br />PLEASE 00 NOT WRITE IN THIS SPACE <br />Pursuant to the revenue laws of the State of Nebraska, notice is hereby <br />given that the State Tax Lien which has been duly filed by the Nebraska <br />Department of Revenue against the below -named taxpayer, is <br />terminated, partially released, or subordinated to the extent indicated <br />below. <br />Nebraska Identification Number <br />11240393 <br />Federal Identification Number <br />26-3482260 <br />Social Security Number <br />xxx-xx-2922 <br />Spouse's Social Security Number <br />Lien Serial Number <br />11301661 <br />Lien filed with <br />Date of Lien <br />09/1312013 <br />Tax Category <br />01 <br />County <br />Hall <br />© Register of Deeds 0County Clerk <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />Name <br />Chris Green <br />Street Address <br />Street or Mailing Address <br />10437 CR 270 <br />City State Zip Code <br />City State Zip Code <br />Carl Junction MO 64834 <br />Type of Action <br />TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated UCC Inst Number 99137229360 <br />County Inst Number 201307663 <br />TAX YEARS (corporate, individual income, and withholding tax only) 2012 <br />0 PARTIAL RELEASE. <br />The State Tax Lien is partially released as follows: UCC Instrument Number <br />County Instrument Number <br />TAX YEARS (corporate, individual income, and withholding tax only) <br />SUBORDINATION. The State Tax Lien is subordinated as follows <br />UCC Instrument Number <br />County Instrument Number <br />sign <br />here <br />I hereby ify that the N - .raska Department of Revenue has complied with the revenue laws of the State of Nebraska in <br />deterrni '.n • the terrain •artia release. or subordination indicated above. <br />� <br />ets Signatu <br />uthorized Signature <br />Revenue Senior Ages <br />3 -.0% <br />402 471-5707 <br />Title Date Telephone Number <br />Revenue Senior Agent � p. v�€' <br />Title Date <br />a?32 68 Rev 856 S-perse8es 4-232.03 Rev. '0.95 <br />