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q) <br />1\5344,46 -KA <br />Goo <br />EB K; - <br />Goo i L;fe. &real Sr rv:cc. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2109001216-0 Pages: 1 <br />Debtor Name: ROBERTO J MONTEJO <br />Filing Date and Time: 09/24/2021 09:45 AM <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 />11918500 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -7410 <br />Spouse's Social Security Number <br />Lien Serial Number <br />11600167 <br />Lion Filed With <br />Secretary of State, Register of Dods <br />Dare of Lion <br />10/20/2016 <br />Tax Program <br />1 <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />1 <br />ROBERTO J MONTEJO <br />236 W ROBERTS ST <br />GRAND ISLAND NE 68803 <br />las Years 2015,2016 <br />UCC Instrument Number 99167833444 <br />County Instrument Number 201608057 <br />Type of Action <br />0,74 <br />Termination of Tax -the State Pax Lien is hereby fully terminated. <br />Lien <br />I hereby certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska in determination of the <br />continuattb'4, termination. partial releas7 subordination indicated above. <br />7/7.4'' RevenuA <br />e ecpt 09/20/2021 (402}471-571 l <br />Signature Title Date Phone Number <br />Email A <br />A on <br />�1>;•� r'r Revenue Senior Agent <br />e Signature Tee <br />9X1 <br />Date <br />4.232-1988 Rev. 8-201 B <br />S:Jpitsede4 4-2321 t 9811 Reb. 1.20!5 <br />