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NE Sec of State - Roben B. Evnen <br />Filing Document #: 2304001223-3 Pages: 1 <br />Debtor Name: CHAN C. Y1M <br />Filing Date and Time: 04/27/2023 10:33 AM <br />J <br />202 302045 <br />STATE TAX LIEN • NEBRASKA DEPARTMENT OF LABOR <br />• TERMINATION <br />NDOL General Counsel <br />P.O. Box 94600 <br />Lincoln, NE 68509-4600 <br />Telephone - (402) 471-9912 <br />FAX - (402) 471-9917 <br />Employer or Liable Person: Chan C. Yim <br />Address: 1709 Bass Rd. Grand Island NE 68801 <br />NDOL Serial Na: I LAB -0475-2012 <br />NDOL Acct. No.: xxxxxx2001 <br />Federal ID No.1 SSA No.: . xx-xxxN/A / xxx-xx-1323 <br />To be filed in the State Tax Lien Register maintained by the <br />Register of Deeds in the following County/Counties: <br />Hall <br />State Tax Lien to be TERMINATED: <br />STL Document Number: STL Date !Time: <br />County Filing Number: County Dale / Time: <br />9912704649-7 (original) 12/14/2012 @ 11:02 AM <br />201210676 <br />12/1412012 04:19 PM <br />I CERTIFY that this TERMINATION serves to remove the lien described above and the priority of the Nebraska Department of Labor on the <br />affected property of this employer or person, and that it is filed pursuant to Neb. Rev. Stat. §§48-657, 48-660.01, 48-664, and the Uniform State <br />Tax Lien Registration & Enforcement Act (Neb. Rev. Stat. §77-3901, et seq.). <br />Date: April 20, 2023 <br />By: <br />KATIE S. THURBER, General Counsel <br />GERALD PANKONIN, Legal Counsel <br />JOHN H. ALBIN, Commissioner of Labor <br />..-,C>o era; CoorKiaLeciafOOCUMENTS,Stve Tax L,a,n,S FL hhr,gs D3 3C,0X 030_C3 3:002 301 12- 3-2312 1Ct:an; tr:rs.do“ <br />Return Filed Copies To: <br />NDOL General Counsel <br />P.O. Box 94600 <br />Lincoln NE 68509-4600 <br />NE Department of Labor <br />Charge Account #14765 <br />