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PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />I1Fovn <br />Good Life. Great Service. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2103000658-1 Pages: 1 <br />Debtor Name: DHOOFO MOHAMED <br />Filing Date and Time: 03/11/2021 1024 AM <br />`'02102035 <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 Number <br />98352873 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -3612 <br />Spouse's Social Security Number <br />Lien Serial Number <br />11160111 <br />Lien Filed With <br />Secretary of State, Register of Deeds <br />Date of Lien <br />08/18/2011 <br />Tax Program <br />22 <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />I <br />DHOOFO MOHAMED <br />5841 N WINTHROP AVE APT 512 <br />CHICAGO IL 60660 <br />Tax Yearn 2008 <br />UCC Instrument Number 99116696681 <br />County Instrument Number 201106204 <br />Type of Action <br />® Continuation of Tax <br />Lien <br />This is a continuation of an existing lien and serves to continue the lien and priority of the Nebraska Department of Revenue <br />for an additional 10 years. <br />I hereby certify that the Nebraska Department of Revenue has complied with tie laws of the State of Nebraska In determination of the <br />continuation, termination, partial release, or subordination indicated above. <br />Preparer's Signature <br />!rah nohlr@' nehraska gov <br />Erma Address -i <br />'Author edture <br />.-Revenue Supervisor 01/02/2021 (308)612-1205 <br />Title Date Phone Number <br />Revenue Supervisor 03/02/2021 <br />Title <br />Date <br />e -MAW tier. a-2et8 <br />Supersedes 4.212-19ee nee. t -tots <br />