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202205120
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7/12/2022 3:25:56 PM
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7/12/2022 3:25:56 PM
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202205120
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NE Sec of State - Robert B. Evnen <br />Filing Document #: 2207000686-9 Pages: 1 <br />Debtor Name: TASHA L MILLER <br />Filing Date and Time: 07/12/2022 09:57 AM <br />202205120 <br />�„• <br />State Tax Lien Statement of Termination or <br />REVENUE Certificate of Partial Release or <br />Subordination <br />LEASE DO NOT WRITE IN THIS SPACE <br />Pursuant to the revenue laws of the State of Nebraska, notice is hereby <br />given that the State Tax Lien which has been duly filed by the Nebraska <br />Department of Revenue against the below -named taxpayer, is <br />terminated, partially released, or subordinated to the extent indicated <br />below. <br />Nebraska Identification Number <br />39037614 <br />Federal Identification Number <br />Social Security Number <br />XXX -XX -5962 <br />Spouse's Social Security Number <br />Lien Serial Number <br />12052750 <br />Lien filed with Register of Deeds <br />Date of Lien <br />04/16/2020 <br />Tax Category <br />22 <br />County <br />HALL <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />t <br />TASHA L MILLER <br />2414 WEST 1ST ST <br />GRAND ISLAND NE 68803 <br />Type of Action <br />® TERMINATION OF TAX LIEN. The State Tax lien is hereby fully terminated. <br />TAX YEARS 2015 <br />(corporate, individual income, and withholding tax only) <br />UCC Instrument Number 20040011404 <br />County Instrument Number 202002486 <br />Continuance; UCC Instrument Number <br />Continuance: County instrument Number <br />o PARTIAL RELEASE. The State Tax Lien is partially released as follows: <br />TAX YEARS <br />(corporate, individual income, and withholding tax only) <br />UCC Instrument Number <br />County Instrument Number <br />0 SUBORDINATION. The State Tax Lien is subordinated as follows. <br />UCC Instrument Number <br />County Instrument Number <br />sign <br />here <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in <br />determination of the termination, partial release, or subordination incicated above. <br />Yue <br />Signa4164,0, <br />r>! <br />Revenue Agent <br />Trite <br />Revenue Supervisor <br />07/06/2022 (308)632-1203 <br />Date Telephone Number <br />07/06/2022 <br />Authorized Signature Title <br />Date <br />4.232-49 Rev 643e Supersedes 4.232-e9 Rev. 10-96 <br />
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