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Dg <br />Good UfaGre�=-- SerrT.cINERAe <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2112001517-0 Pages: 1 <br />Debtor Name: DEWAYNE SHORT <br />Filing Date and Time: 12/30/2021 11:05 AM <br />202111061 <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 StateTax Uen <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 />PIO`fe DO Not Write In This space <br />Nebraska ID Number <br />46653147 <br />Federal ID Number <br />Social Sar:urity Number <br />XXX -XX -1025 <br />Spouse's Social Security Number <br />Lien Serial Number <br />11547522 <br />Lien Filed With <br />Secretary or State, Register of Deeds <br />Dae of Lien <br />02/24/2015 <br />Tax Program <br />22 <br />County <br />HALL <br />Business Name and Location Address <br />Taxsayer Name and Mailing Address <br />1 <br />DEWAYNE SHORT <br />PO BOX 150 <br />DONIPHAN NE 68832 <br />Tax Years 2012: 2013 <br />UCC Instrument Number 99157498058 <br />County Instrument Number 201501246 <br />Type of Action <br />® Termination of Tax The State Tax 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 />continuation, termination, partial release, or subordination indicated above. <br />'aridel-Martin, Revenue Agent 12/27/2021 (308)632-1210 <br />Signature Tri Date <br />Phone Number <br />hridoet martin(pinebracka.gov <br />Email Address <br />/1/I'Autf r S7yt Revenue Supervisor 12/27/2021 <br />-.. (,r lufe Title Date <br />4232.1968 Rev. 8-2018 <br />Swansea* 4232-1968 Her 1.2016 <br />