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Goods LiFe. Great Sery<ce. <br />001.1011.11. INPV00011 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2203001003-3 Pages: 1 <br />Debtor Name: JESUS FLORES SERVIN <br />Filing Date and Time: 03/17/2022 11:46 AM <br />202201948 <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 />40167283 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -6706 <br />Spouse's Social Security Nan ter <br />Lien Serial Number <br />12053235 <br />Lien Filed With <br />Secretary of State. Register of Deeds <br />Date of Lien <br />04/23/2020 <br />Tax Program <br />22 <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />JESUS FLORES SERVIN <br />1627 S SYLVAN ST <br />GRAND ISLAND NE 68801 <br />-fax Years 2016 <br />11CC instrument Number 20040013794 <br />County Instrument Number 202002598 <br />Type of Action <br />-Termination of Tax <br />Lien <br />The Stale Tax Lien is hereby fully terminated., <br />I hereby certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska in determination. 01 the <br />continuation, termination, partial release, or subordination indicated above. <br />r f repa'ea Signature <br />Revenue Agent <br />Title <br />03/10/2022 (10S)6'i2-1219 <br />Date Phone Number <br />i/11646 - <br />Authorized Signature <br />Revenue Supervisor <br />Title <br />03)10 2022 <br />Date <br />4-232-1986 Rebs, 8.201e <br />Supersedes 4.232-1968 Rev. 1-2510 <br />