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NE Sec of State - Robert B. Evnen <br />Filing Document #: 2107001205-6 Pages: 1 <br />Debtor Name: KYLE S USREY <br />Filing Date and Time: 07/21/2021 10:52 AM <br />202106193 <br />--'r--- State Tax Lien Statement of Termination or <br />ti••t4.Mak• 0'o+.mann N <br />REVENUE Certificate of Partial Release or <br />www...v.r.k.r.aw <br />Subordination <br />PLEASE 00 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 />44704402 <br />Federal Iden66calion Number <br />Social Security Number <br />XXX -XX -9494 <br />Spouse's Social Security Number <br />Lien Serial Number <br />12063350 <br />Lien filed with Register of Deeds <br />Date o( Lien <br />10/09/2020 <br />Tax Category <br />22 <br />County <br />HALL <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />KYLE S USREY <br />706 W HEDDE ST APT 13 <br />GRAND ISLAND NE 68801 <br />Type of Action <br />® TERMINATION OF TAX LIEN. The State Tax Len is hereby toy terminated. <br />TAX YEARS 2016 <br />(corporate, Individual income, and withholding tax only) <br />UCC Instrument Number 20100008173 <br />County Instrument Number 202008044 <br />Continuance: UCC Instrument Number <br />Continuance: County instrument Number <br />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 />SUBORDINATION. The State Tax' Lien is subordinated as follows. <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 in <br />determination of the termination, partial release. or subordination indicated above. <br />Revenue Agent <br />Preparers Si tore Q9 Title <br />IAA <br />AuthorizE$ Signature `� Title Date <br />4232.66 Rev. a -w 64 09,9464 8-23249 949 '.490 <br />Revenue Supervisor <br />07/14/2021 (402)471-5713 <br />Date Telephone Number <br />07/14/2021 <br />