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PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />111111111111111111111111101111111111111110111111111 <br />202101129 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2102000361-9 Pages: 1 <br />Debtor Name: DEBORAH A MERRICK <br />Filing Date and Time: 02/09/2021 10:26 AM <br />1.114 ---� State Tax Lien Statement of Termination or <br />fiee.eHe b.n,.w.eml <br />REVENUE Certificate of Partial Release or <br />w........._ .._ Subordination <br />PLEASE DC 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 />35744871 <br />Federal identification, Number <br />Social Sexmty Number <br />XXX -XX -2323 <br />Spouse's Social Security NN-.rnber <br />Lien Serial Number <br />12066790 <br />Lien filed with Reglstet of Deeds <br />Date of Lien <br />12/17/2020 <br />Tax Category <br />22 <br />County <br />HALL <br />I BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />DEBORAH A MERRICK <br />10711 E 24TH ST S <br />INDEPENDENCE MO 64052 <br />Type of Action <br />TERMINATION OF TAX LIEN. The State Tax Lien is hereby tufty *manatee/. <br />TAX YEARS 2017.2018 <br />(corporate, individual income, and withholding tax only) <br />UCC Instrument Number 20120012369 <br />County Instrument Number 202010262 <br />Continuance: UCC Instrument Number <br />Continuance: County Instrument Number <br />0 PARTIAL RELEASE, The State Tax Lien is banally released as fol; <br />TAX YEARS <br />(corporate, individual income, and withholding tax only) <br />UCC Instrument Number <br />County Instrument Number <br />0 SUBORDINATION. The State Tax Lien is subord!nated as follows. <br />UCC Instrument Number <br />County Instrument Number <br />I hereby certify that the Nebraska Department of Revenue has complied wnth the revenue laws ofthe .tale of Nebraska in <br />determination cf the te.ennationpartial reeease. ce subord:<<nat0 ntkcated abme. <br />sign Revenue Agent <br />here <br />Act ho zed S+tanature <br />02/05/2021 (402)370-3121 <br />T:5e Date Telephone Number <br />Revenue Supervisor 02/05/2021 <br />Title Date <br />t-23248 ger. 406 Su mentis 4.23260 Rev 2205 <br />