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NE Sec of State - Robert B. Emen <br />Filing Document #: 2306000592-1 <br />Debtor Name: GERALD D. MYERS <br />Filing Date and Time: 06/23/2023 09:38 AM <br />Pages: 1 <br />202303136 <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: <br />Address: <br />Gerald D. Myers f!d/b/a Bubba Jers Family Diner <br />2028 East Hightway 30 Grand Island NE 68801 <br />NDOL Serial No.: LAB -0024-2013 <br />---_—__--_— --------------- <br />WOOL Acct. No.: xxxxxx0004 <br />Federal ID No. I SSA No.: xx-xxx7412 I xxx-xx-2482 <br />State Tax Lien to be TERMINATED: <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 />1 <br />STL Document Number. STL Date i Time: County Filing Number: County Date 1 Time: <br />9913708157-0 (original) <br />02/07/2013 @ 10:34 AM <br />201301032 <br />02/07/2013 t 02:31 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 flied pursuant to Nab. Rev. Stat- §§48-657, 48-660.01, 48484, end the Uniform State <br />Tax Lien Registration & Enforcement Act (Neb. Rev. Stat. §77-3901, et seq.). <br />Date: June 12, 2023 By: <br />Cowls <br />JOHN H. ALBIN, Commissioner of Labor <br />TIE S. TtiUf3B$R, General Counsel <br />GERALD PANKONIN, Legal Counsel <br />al;ttOCWOE N TStstato TatSTL. r3sys103 40704 000,03 43170 004 02-07-2013 trrn4;ra <br />Return Filed Copies To: <br />NDOL General Counsel <br />P.O. Box 94600 <br />Lincoln NE 68509-4800 <br />NE Department of Labor <br />Charge Account#14765 <br />