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N <br />Good life. Great Service. <br />P•84.111111.141r •••••04111 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2112001200-3 Pages: 1 <br />Debtor Name: DANA .1 PETERSON <br />Filing Date and Time: 12/22/2021 08:55 AM <br />202110827 <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 />23251530 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -4029 <br />Spouse's Social Security Number <br />XXX -XX -7392 <br />Lien Serial Number <br />11555330 <br />Lien Filed Web <br />Secretary of Slate, Register of Deeds <br />Dale of Lien <br />07/27/2015 <br />Tax Program <br />22 <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />DANA) PETERSON <br />PAMELA L PETERSON <br />4728 DEVA DR <br />GRAND ISLAND NE 68801 <br />Tax Years 2008 <br />UCC Instrument Number 99157586740 <br />County instrument Number 201505167 <br />Type of Action <br />® Continuation of Tax This is a continuation of an existing hen and serves to continue the lien and priority of the Nebraska Department of Revenue <br />I..ien for an additional 10 years. <br />I hereby certify that the Nebraska Department of Revenue has conptied with the las of the State of Nebraska in determination of the <br />continuation, termination, penal release, or subordination Indicated above. <br />Revenue Agent 12/17/2021 (402)471-5712 <br />Preparer's Signature Tek Date Phone Number <br />chris diftmar@nebrarka goy <br />Email Address <br />' I 44S�.2 Revenue Supervisor 12/17/2021 <br />Authorized Signature Title Date <br />4-232-te68 new S-20te <br />Supersedes 4.232-1ees Rev. 1.2015 <br />