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6/5/2020 3:42:10 PM
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6/5/2020 3:42:10 PM
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202003711
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a, <br />0 <br />ry=a -K. <br />202003711 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2006000306-9 Pages: 1 <br />Debtor Name: CASEY T CAMPOS <br />Filing Date and Time: 06/05/2020 10:05 AM <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 IC Number <br />45582815 <br />Ferkoal IC Number <br />Social Security Number <br />XXX -X X-7033 <br />Spouse's Social Security Number <br />Len Serial Number <br />11439982 <br />Lien Filed With <br />Seeretars of State, Register of Deeds <br />Date of Lien <br />09/18/2014 <br />lox Program <br />22 <br />1 County <br />IIAI.I. <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />CASEY T CAMPOS <br />922 F. 12111 SI <br />GRAND ISLAND NE 68801 <br />lax Years 2009 <br />UCC Instrument Number 99147422324 <br />Count} Instrument Number 201406025 <br />Type of Action <br />® I-ermination of 'fax 1 he State Fax Lien is hembq fully terminated. <br />Lien <br />I horeoy certify that the Nebraska Department of Revenue has complied will the laws of the State of Nebraska ,n determination of the <br />cwNneation, termination, portal release. or subordination indicated alcove. <br />/Prepirer's Signature <br />F mail Adrtress <br />VAuttbnzed Siynatur4 <br />Revenue Agent -4b/:03'2_020 14073471-57f1 <br />Title Date Pune Number <br />1Q( OJ 2020 <br />4.232-196B Pp, 6.20re <br />S.plrttdOt a-232-1968 °ov 20!5 <br />
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