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Good Life, Greet Service. <br />NE Sec of State - Robert B. Evnen 202300666 <br />Filing Document #: 2302000363-5 Pages: 1 <br />Debtor Name: JOSE I RUIZ TAPIA <br />Filing Date and Time: 02/10/2023 09:35 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 Witte MTh's Space <br />Nebraska ID Number <br />42649919 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -0056 <br />Spouse's Social Security Number <br />Uen Serial Number <br />12182097 <br />Lien Fred With <br />Secretary or State, Register of Deeds <br />Date of Uen <br />10/05/2021 <br />Tax Program <br />22 <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Meiling Address <br />JOSE I RUIZ TAPIA <br />1408 SOUTH EDDY <br />GRAND ISLAND NE 68801 <br />Tax Years 2017: 2018 <br />UCC Instrutnent Number 21100004583 <br />County Instrument Number 202108730 <br />Type of Action <br />® Termination of Tax <br />Lien <br />The State Tax Lien is hereby fully terminated. <br />I hereby certify that the Nebraslm Department of Revenue has complied with the laws of the State of Nebraska in determination of the <br />continuation, termination, partial release, a subordination indicated above. <br />Revenue Agent 02/07/2023 (402)471-5712 <br />Preparers Signature Title Dare Phone Number <br />chris.dittmar@nebraska.gov <br />r „ Revenue Supervisor 02/07/2023 <br />Title Date <br />4292.1968 Rev. 8.2018 <br />Supenadae 4232.1968 Re. 1.2015 <br />