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. .2RA&KA <br />Good life. Great Service. <br />...a,«...ararvaxw <br />202305740 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2310000806-4 Pages: 1 <br />Debtor Name: JUSTIN ANDERSON <br />Filing Date and Time: 10/31/2023 10:39 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, theNesse <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 />Do Not Write In This Space <br />Nebraska It) Number <br />95848371 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -8211 <br />Spouse's Social Security Number <br />Lien Serial Number <br />11789665 <br />Lien Filed With <br />Secretary of State, Register of Deeds <br />Date of Lien <br />06/15/2017 <br />Tax Pegram <br />22 <br />County <br />HALL <br />1 Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />JUSTIN ANDERSON <br />3391/2 S OAK ST <br />GRAND ISLAND NE 68801 <br />Tax Years 2014 <br />UCC instrument Number 99177938842 <br />County Instrument Number 201704146 <br />Type of Action <br />® Termination of Tax <br />Lien <br />The Slate Tax Lien is hereby fully terminated <br />I hereby certify that 1110 Nebraska Department of Revenue Ms complied with the taws of the State of Nebraska In determination of the <br />continuation, termina0on, partial release, or subordination indicated above. <br />5'6z4G2r y54 Revenue Agent 10/19/2023 (308)632»1208 <br />OPreparer's Signature Title Date Phone Number <br />sara.holliday@nebraska.gov <br />Email Address <br />I g,a4 42061E, Revenue Supervisor 10/19/2023 <br />Authorized Signature Title Date <br />Haat tare Rev. B ROta <br />Supersades 4.232 -tete Rev. 1.2019 <br />