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202005411 <br />NI Sec of State - Robert ti. I'vnen <br />Filing Document #: 2007001142-9 Pages: 1 <br />Debtor Name: JEFFERY C GREEN <br />Filing Date and Time: 07/28/2020 09:06 AM <br />milh,'`h;;, State Tax Lien Statement of Termination or <br />REVENUE Certificate of Partial Release or <br />Subordination <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 />PLEASE DO NOT WRITE IN THIS SPACE <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />Nebraska Identification Number <br />97648310 <br />Federal Identification Number <br />Social Security Number <br />XXX -XX -4556 <br />Spouse's Social Security Number <br />ben Serial Number <br />12052341 <br />Lien filed with Register of Deeds <br />Date of Uen <br />04/09/2020 <br />Tax Category <br />22 <br />County <br />HALL <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAIUNG ADDRESS <br />JEFFERY C GREEN <br />2020 COTTAGE <br />GRAND ISLAND NE 68803 <br />Type of Action <br />® TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. <br />TAX YEARS 2017 <br />(corporate, individual income, and withholding tax only) <br />UCC Instrument Number 20040007535 <br />County Instrument Number 202002376 <br />Continuance: UCC Instrument Number <br />Continuance: County Instrument Number <br />o PARTIAL RELEASE. <br />TAX YEARS <br />(corporate, individual income, and withholding tax only) <br />The State Tax Lien is partially released as follows: <br />UCC Instrument Number <br />County Instrument Number <br />El SUBORDINATION. The State Tax Lien is subordinated as follows <br />UCC Instrument Number <br />County Instrument Number <br />I hereby certify that the Nebraska Department of Revenue has complied wittt the revenue laves of the State of Nebraska in <br />determination termination. partial release, or subordination indicated move. <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />07/23/2020 (308)632-1203 <br />Date Telephone Number <br />07/23/2020 <br />Title <br />Date <br />4.232.66 Rev e66 Sepaned*, 4 232 69 liar . 1696 <br />