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Cloud I.,l« fuea', 5err+re. <br />202304478 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2308000779-6 Pages: 1 <br />Debtor Name: CAMERON L WERTZ <br />Filing Date and Time: 08/25/2023 10:37 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 duty filed of record as indicated, Is continued, terminated, <br />partially released, or subordinated, to the extent indicated below. <br />Nebraska 10 dumber <br />Federal 10 Number <br />Please Do Not Witte In This Space <br />99880741 <br />ton Serial Number Llan. Flied With <br />11428945 Secretary or State, Register of <br />Business Name and Location Address <br />Social Seaway Nombet <br />XXX -XX -3588 <br />Date of Late <br />01/31/2014 <br />Spouses Social Seeuriy Noineer <br />22 <br />County <br />HALL <br />Taxpayer Name and Melling Address <br />CAMERON L WERTZ <br />404 W 15TH ST <br />GRAND ISLAND NE 68801 <br />Tax Years 2007: 2011 .} c,/ ,77 2 7 I-> <br />UCC Instrument Number 9914729959&__. County Instrument Number 201400655 <br />Type of Action <br />Termination of Tax The State Tax Lien is hereby fully terminated, <br />Lien <br />f Hereby certify that the Nebraska Department of Revenue has ceenpree with Me tears of the State of Nebraska In delemnnation ti the <br />eonerwidwr. laminatiork partial release, or subordinaion imitated above. <br />Revenue Senior Agent 08/04/2023 (402)471-4339 <br />Pe.erer s Signature Title Date Phone Numbs: <br />brandon. brown@nebrasiw. gov <br />Email <br />Address <br />zed Sigralurd <br />Revenue Supervisor 08/04/2023 <br />tide Dale <br />4-832-19813 Rev. 84018 <br />Supsreeden 4433 -ales Rev. 14015 <br />