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NR <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2007001039-6 Pages: 1 <br />Debtor Name: CLUB 69, INC. <br />Filing Date and Time: 07/24/2020 08:58 AM <br />202005332 <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 Nurnber ' Federal ID Number <br />9677003 20-3658058 <br />Social Security net <br />Spouse's Social Security Number <br />Lien Serial Number <br />11150766 <br />Lien Vied With <br />Secretary of State, Register of Deeds <br />Date of Len <br />12/03/2010 <br />Tax Pro rarn County <br />01 HALL <br />Business Name and Location Address Taxpayer Name and Mailing Address <br />CLUB 69. INC. <br />719\k'3RD Sr <br />GRAND ISL -AND NE 68801 <br />Fax Years 0110-3110 <br />10 <br />UCC Instrument Number 9911648551-9 County Instrument Number 201100419 <br />Type of Action <br />Continuation of Fax This is a continuation Of an existing lien and serves 10 continue !lir lien and priority of the Nchraska Department or Revenue <br />1.ien tar an additional 10 years. <br />1 <br />illy that the Nebraska Department of iif*01*00 has oornEhed wahit ssa I of One State of Nobles in UetertrarW00rt t> the: <br />CC*1:003300. torm:rafdn. aanial release, or subordination irchcated 96200. <br />OPreparer'x Stgnature <br />Rt; true Agent 07t',011.070 (402)471-6067 <br />Phone Number <br />Title Date <br />liz tonuc Senior Agent 7/ 2'0/ z -d ) <br />Date <br />Tate <br />44322-10Ce nee. 04019 <br />Seperrse0e s 4.232.1960 Heb. I.2C 1S <br />