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N_E .644 A <br />CObr.:.In Gn?ac ger —e. <br />LULzui vui <br />NE Sec of State - Robert B. Evnen <br />Filing Document If: 2210000876-4 Pages: 1 <br />Debtor Name: CHASE A SMITH <br />Filing Date and Time: 10/25/2022 10:06 AM <br />202207607 <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 />90353331 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -5466 <br />Spouse's Social Security Number <br />Lien Serial Number <br />12299288 <br />Lien Filed With <br />Secretary of State. Register of Deeds <br />Dale of Lien <br />05/12/2022 <br />Tax Program <br />22 <br />County <br />NALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />CHASE A SMITH <br />321 E 6711 <br />GRAND ISLAND NE 68801 <br />'fax Years 2020 <br />UCC Instrument Number 22050007091 County Instrument Number 202203613 <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 o1 Nebraska in determination at the <br />continuation, termination, partial re40ase, or subordination indicated attune. <br />Revenue Agent 10/19,2022 (308)632-1206 <br />Prrparer's Signature Title Date Phone Number <br />d i a ne. r i c kard (u, nc b ra s k a. gov <br />Email Address <br />'LAI,-.4.1:'�Br�O Revenue Supervisor 10/19/2022 <br />Authorized Signature Title Date <br />4.232-,968 Rev. 240,8 <br />SLpenedes 4.232-t098 Ren 1-20,5 <br />