Laserfiche WebLink
NEAR S-KAr. <br />C:x,9 t. dr. Gres::;era.rn <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2109000706-1 Pages: 1 <br />Debtor Name: HARVEY EVANS <br />Filing Date and Time 09/15/2021 09:34 AM <br />20210786g <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 <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 />Please Do Not Write In This Space <br />Nebraska ID Number <br />39756572 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -0268 <br />Spouse's Social Security Number <br />Lien Serial Number <br />121 77392 <br />Lien Filed With <br />Secretary of State, Register of Deeds <br />Date oIL en <br />07/28/2021 <br />Tan Program <br />22 <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />HARVEY EVANS <br />PO SOX 1285 <br />GRAND ISLAND NE 68802 <br />Tax Years 2019 <br />tICC Instrument Number 21070019679 <br />County Instrument Number 202106515 <br />Type of Action <br />Termination of lax The State Tax Lien is hereby filly laminated. <br />Lien <br />I hereby candy that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska in determination of the <br />contrnuation, termination, partial release, or subordination indicated above. <br />Revenue Agent 09/09/2071 (4021471-0987 <br />Preparei s Signature T pe Date Phone Number <br />than tang(a)nehraska gnv <br />Email Address <br />r Revenue Supervisor 09/09/2021 <br />dAythorized Signalu>'e Title Data <br />4-232.1988 Rev. 8-2018 <br />Scperaedea w232.1965 Rev. 1.2015 <br />