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nlEB- <br />Gooc L le. Great Service. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2111001286-4 Pages: 1 <br />Debtor Name: JOSE T GARCIA <br />Filing Date and Time: 11/23/2021 11:42 AM <br />202109989 <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 writs In This Space <br />Nebraska ID Number <br />99982609 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -5174 <br />Spouse's Social Security Number <br />Lien Serial Number <br />12178414 <br />Lien Filed With <br />Secretary of State, Register of Deeds <br />Dale of Lien <br />08/11/2021 <br />Tar Program <br />22 <br />County <br />HALL <br />I Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />1 <br />JOSE T GARCIA <br />1414 SAINT PAUL RD APT 81 <br />GRAND ISLAND NE 68801 <br />Tax Years 2016: 2018 <br />IJCC Instrument Number 21080007789 <br />County Instrument Number 202106947 <br />Type of Action <br />® Termination of Tax <br />Lien <br />The State Tax Lien is hereby fully terminated. <br />I hereby certify that the Nebraska Department of Revenue has complied with the laws of the Stale of Nebraska In determination of the <br />continuation. termination. partial release, or subordination indicated above. <br />` Revenue Agent 11/1507021 (40207I-6043 <br />treparer's Sgnature Tile Date Phone Number <br />ashley bivens@nebraska goy <br />Email Address <br />..ice':...! .!„�IC'�/''"•:.r r',•""j` <br />xythorzed Slenatuje <br />Revenue Supervisor 11/15/2021 <br />line Date 4232.19e0 ttw. t-2015 <br />Supersede. 4232-1981 Rev. 1.2015 <br />