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NEER -AG -KA_ <br />:..10:1 n'c. cori Ser a r'u <br />Or <br />202207735 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2210001014-9 Pages: 1 <br />Debtor Name: TIMOTHY S SMITH <br />Filing Date and Time: 10/31/2022 10:01 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 hinds Space <br />Nebraska ID Number <br />431362 14 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -1057 <br />Sono aax Soraal Security Number <br />Len Serial Number <br />12174474 <br />lien Filed With <br />Secretary of State, Register of Deeds <br />Date of Lien <br />06/02/2021 <br />Tax Program <br />22 <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and MailnJ Address <br />TIMOTHY S SMITH <br />19617 BLAINE CIR <br />OMAHA NE 68135 <br />Tax Years 2018: 2(119 <br />UCC Instrument Number 21060003624 <br />County Instrument Number 202104855 <br />Type of Action <br />®'term ination of Tax <br />Lien <br />lle Slate 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 of the <br />continuation, te,o nutitm, motel release, or subordination indicated above. <br />Optoparer's Signature <br />laurie.madsen gnebraska.gov <br />Taxpayer Services Specialist II 10/26/2022 (402)471-5916 <br />Tile Date Rhone Number <br />Email Address <br />Revenue Supervisor 10/26/2022 <br />Authorized Signature Tile Date <br />8.232.1068 nev. 8-2018 <br />Supersedes 4.2232.1068 Rev. 1.2015 <br />