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1/3/2022 9:18:48 AM
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202111062
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Gooc Life. Great Service. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2112001518-9 Pages: 1 <br />Debtor Name: DEWAYNE SHORT <br />Filing Date and Time: 12/30/2021 11:06 AM <br />202/11069, <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 />46653147 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -1025 <br />Spouse's Social Society Number <br />Lien Serial Number <br />11044244 <br />Lien Filed With <br />Secretary of State, Register of Deeds <br />Dale of Lien <br />09/07/2010 <br />Tax Program <br />22 <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />DEWAYNE SHORT <br />PO BOX 150 <br />DONIPHAN NE 68832 <br />Tax Years 2008 <br />UCC Instrument Number 99106369193; 20030007518 <br />County Instrument Number 201006497; 202001687 <br />Type of Action <br />® Termination of Tax The State Tax Lien is hereby fully terminated. <br />Lien <br />I hereby certiy that the Nebraska Department of Revenue has complied with the tam of the State of Nebraska In determination of the <br />continuation,termination, partial release, or subordination Indicated above. <br />►F reh ata"'totrtu i <br />bridgeLrnartin@nehraska.gov <br />ska.gov <br />Email 7adddress <br />Rev8pue Agent 12/27/202I (308)632-1210 <br />Title Date Phone Number <br />Revenue Supervisor 1227/2021 <br />Tile Date <br />4.232.1908 Rae. 84018 <br />Suporeedee 4232.1968 Rev. t-2015 <br />
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