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NE Sec of State - Robert B. Evnen <br />Filing Document #. 2105000993-9 Pages: 1 <br />Debtor Name: WILLIS WORKWEAR LLC <br />Filing Date and Time: 05/21/2021 10:31 AM <br />202104307 <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 Please Do Not Write In This Space <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 />Neb'a0 a 10 Number 1 fede-ai ID Namara ' Social Security Number Spouses Social Socuety Number <br />12683167 814289230 <br />L+an Serial Number 1 Lien Fitt WO Dale of Lien Tar Program County <br />12167536 Secretary of State. Register or Deeds 01/20/2021 1 HALL <br />Business Name and Location Address Taxpayer Name and Mailing Address <br />WILLIS WORKWEAR LLC <br />2621 BRAHMA ST <br />GRAND ISLAND NE 68801 <br />Tar Years 2019, 2020 <br />UCC Instrument Number 21030003_1--0 County Instrument Number 20210107 <br />Type of Action <br />®'termination of Tax The State Tax Lien is hereby filly terminated. <br />Lien <br />1 hereby cerhty that the Nebraska Department of Revenue has complied with Ile laws of the State of Nebraska in determination of the <br />oontinuation...6ammation. partial fulness. or subordination indicated above. <br />07 <br />tura" - <br />rrika.nthles(n nehrasku gov <br />Entad Address <br />0�A;tMpdzed Signature <br />Revent tc Apent 05,10/2021 1402)471-5956 <br />Tine Date Phone Number <br />Revenue Supervisor <br />Title <br />5/10/2021 <br />Dale <br />4-232-td69 Rev. a-213:9 <br />Srew tildes 4.232,993 nr... r-20-.5 <br />