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202103295
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4/22/2021 4:05:29 PM
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4/22/2021 3:57:38 PM
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202103295
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NE Sec of State - Robert B. Evnen <br />Filing Document #: 2104001379-3 Pages: 1 <br />Debtor Name: GARY F MEYER <br />Filing Date and Time: 04/22/2021 09:32 AM <br />202105295 <br />State Tax Lien Statement of Termination or <br />REVENUE Certificate of Partial Release or <br />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 />46326588 <br />Federal Identification Number <br />Sooal Security Number <br />XXX -XX -0027 <br />Spouse's Social Security Number <br />Lien Serial Number <br />11153721 <br />Lien filed with Register of Deeds <br />Date of Lien <br />03/29/2011 <br />Tax Category <br />22 <br />County <br />HALL <br />I BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />GARY F MEYER <br />1221 W JOHN <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 2000. 2005, 2006 <br />(corporate, Individual Income, and withholding tax only) <br />UCC Instrument Number 99116567931 <br />County Instrument Number 201102551 <br />Continuance: UCC Instrument Number 20120012554 <br />Continuance: County Instrument Number 202010263 <br />El PARTIAL RELEASE. The State Tax Lien is partially released as follows: <br />TAX YEARS <br />(corporate, individual Income, and withholding tax only) <br />UCC ktslrument Number <br />County Instrument Number <br />0 SUBORDINATION, The State Tax Lien is subordinated as follows. <br />UCC Instrument Number <br />County Instrument Number <br />sign <br />here <br />1 hereby certify that the Nebraska Department of Revenue hors Compiled with the revenue laws of the State 01 Nebraska in <br />determination of the termination, partial release, or subordination indicated above. <br />Revenue Agent 04/15/2021 (308)632-1203 <br />Prepareslyre Tithe Date Telephone Number <br />A�� Revenue Supervisor <br />04/15/2021 <br />AuttCnzed Signature Title Date <br />1.23246 RIv. 698 U0,40**,13249 Rev 10.95 <br />
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