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N,EB AG -K - <br />.0411,04.1 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2104001846-0 Pages: 1 <br />Debtor Name: CONNIE D ROSS <br />Filing Date and Time: 04/27/2021 12:34 PM <br />202.103450 <br />State Tax Lien -- Statement of Continuation or <br />Termination; Certificate of Partial Release <br />or Subordination <br />i Please Do Not Write In This Space <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. I <br />Nebraska 10 Number 1 Federal ID N&^ber Social Snag Nvmner <br />41412826 XXX -XX -5106 <br />Lien Serial Number 5 Lien Filed Mei Date al Lien Tan arogran <br />41412826 Secretory orState. Itegister of Deeds <br />Business Name and Location Address <br />08/11/2004 22 <br />Spcuse's SOCA,",cosy N icaxt• <br />�d:My <br />BALL <br />Taxpayer Name and Mailing Address <br />ROSS-CONNIE 1) <br />223 RED COACT I CI <br />SANFORD FL 32773 <br />lax Years 24•41I-' <br />l''CC Instrument Number c ri .N39 J25 tS j .1q1'173 County Instrutnent Vumhcr 2WL/c) iq 1 ZOit1O/CX <br />Type of Action <br />C°ntin11J110n Of T3% Thi$ is a continuation °ran existing lien and woes to COM tittle the lien and prk)rit) of tle NebraJca Department of Revenue <br />Lien for an additional 10; ears <br />1 <br />1 hereby cert4y Intl Inc Nebraska Department ut FLevenue ban compiled whit ISa Son c{ Ira State ct Nebiasta in determination of die <br />cora. uaeon. termination, pal tial ;ekase. or ss:twrcination indicated above. <br />O'Prepe.er's Signalare <br />than tanar i nrbranka < v <br />Final Address <br />O.Ai iaeiaed Signata e <br />Revenu0Apent 04,07,702L (407)471.0487 <br />Ttle <br />Dare Peen o Number <br />Revenue Supervisor 04'07:2021 <br />i',tle tate <br />.?r,;. d7S'6 <br />S r. eaaen a.2t2."aEa .1a-. 1,101$ <br />