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PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />1111111111111111111 I <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 201) 000969-4 Pages: 1 <br />Debtor Name: CELIA F GARCIA <br />Filing Date and Time: 11/20/2020 10:45 AM <br />202009120 <br />hr6rseks tlwswnwir n er <br />State Tax Lien Statement of Termination or <br />REVENUE Certificate of Partial Release or <br />Subordination <br />PLEASE DO 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 />38023466 <br />Federal IdenEhcatiort. Number <br />Social Security Number <br />XXX -XX -8584 <br />Spouses Social Security Number <br />Lien Serol Number <br />12055776 <br />Lien filed with Register of Deeds <br />Date of Lien <br />06/03/2020 <br />Tax Category <br />22 <br />County <br />HALL <br />' BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />CELIA F GARCIA <br />608 W 7TH STREET <br />GRAND ISLAND NE 68801-4220 <br />Type of Action <br />® TERMINATION OF TAX LIEN. Tne Stale Tax Lien is hereby fully terminated. <br />TAX YEARS 2016,2017,2018 <br />(corporate, individual Income, and withholding tax only) <br />UCC Instrument Number 20060003582 <br />County Instrument Number 202003793 <br />Continuance: UCC Instrument Number <br />Continuance: County Instrument Number <br />ID PARTIAL RELEASE. The State Tax Lien is partially released es follows: <br />TAX YEARS <br />(corporate, individual income, and withholding tax only) <br />UCC Instrument Number <br />County Instrument Number <br />SUBORDINATION. The State Tax Lien Is subordinated as folows <br />UCC Instrument Number <br />County Instrument Number <br />by certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in <br />at of the termination, partial release, or subordination indicated above <br />sign ,_J,? t <br />here Preparers sib <br />2 (l / %a ., Revenue Agent 11/12/2020 (308)632-1208 <br />,cure !"!- Title {- Date Telephone Number <br />I (r Revenue - FE/t /gar Nei r, i, 11/12/2020 <br />Title Date <br />Aid i Signature <br />a 23.2 e35 Re r a to Sumas*. 21249 as. 10.95 <br />