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202104376
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5/24/2021 3:51:22 PM
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5/24/2021 3:51:22 PM
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202104376
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202104376 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2105001060-7 Pages: 1 <br />Debtor Name: QUEVEN E BARRIOS <br />Filing Date and Time: 05/24/2021 09:48 AM <br />,; State Tax Lien Statement of Termination or <br />REVENUE Certificate of Partial Release or <br />Subordination <br />PLEASE DO 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 />95551751 <br />Federal Identification Number <br />Social Security Number <br />XXX -XX -4520 <br />Spouse's Social Security Number <br />Lien Serial Number <br />Date of Lien <br />Tax Category <br />County <br />11939241 <br />Lien filed with Register of Deeds <br />09/26/2019 <br />22 <br />HALL <br />I BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />QUEVEN E BARRIOS <br />316 E 13TH ST <br />GRAND ISLAND NE 68801 <br />Type of Action <br />® TERMINATION OF TAX LIEN. The State Tax List is hereby fully terminated. <br />TAX YEARS 2016 <br />(corporate, individual income, and withholding tax only) <br />UCC Instrument Number 19090014127 <br />County Instrument Number 201906015 <br />Continuance: UCC Instrument Number <br />Continuance: County Instrument Number <br />o PARTIAL RELEASE. The State Tax Lien is partially released as follows: <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 subordinated as fellows. <br />UCC Instrument Number <br />County Instrument Number <br />sign <br />here <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska trt <br />determination of the termination, partial release, or subadinabon indicated above. <br />Revenue Agent 05/18/2021 (402)471-5713 <br />Preps ersibtggat%see� yip <br />ed Sigrtaturei�l' K <br />Title Date Telephone Number <br />Revenue Supervisor 05/18/2021 <br />Title Date <br />4 232411R. 9.96 Supersedes 4.23249 Rev '095 <br />
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