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NIES <br />,hnd I iP. <br />etM410Cni ar rtleaeel <br />2022f17OR5 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2209001161-0 Pages: 1 <br />Debtor Name: KELLIE M CHACON <br />Filing Date and Time: 09/30/2022 10:18 AM <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 />46594469 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -2140 <br />Spouses Social Security Number <br />Lien Serial Number <br />12183252 <br />Tien Fled With <br />SecretaryorState, Register or Deeds <br />Dale of Lien <br />10/21/2021 <br />Tax Program <br />22 <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer <br />Name and Mailing Address <br />I <br />KELLIE M CHACON <br />1114 W LOUISE ST APT 2 <br />GRAND ISLAND NE 68801 <br />Tax Years 2017: 2018 <br />LCC Instrument Number 21100012430 <br />County Instrument Number 202109197 <br />Type of Action <br />Z Termination of '1.ax <br />Lien <br />The State 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 d the <br />continuation. termination. partial release. or subordination indicated above. <br />bridget.martiivibncbraska.gov <br />Revenue Agent 09122/2022 (308)632-1210 <br />Title <br />Date Phone Number <br />Email Address <br />hAuthoried Signaler:44Z. <br />Revenue Supervisor 09'2212022 <br />Title <br />Date 4.232-1988 Rau. 8.1018 <br />Suuerseaes 4-232-1988 Ree. 1.20ts <br />