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Gcod Late. Great Service. <br />en....r.. e, e,vaw, <br />20206 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2311000501-1 Pages: 1 <br />Debtor Name MIGUEL TERCERO BAUTISTA <br />Filing Date and Time: 11/17/2023 09:14 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 hien <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 write M Tins Space <br />Nebraska ID Number <br />46949437 <br />Federal ID Number <br />Social Security Number <br />XXX -XX -6456 <br />Spouse's Social Security Number <br />Lien Serial Number <br />11433414 <br />Lien Fled With <br />Secretary of Stare, Register of Deeds <br />Date of Lien <br />05/01/2014 <br />Tax Program <br />22 <br />County <br />HALL <br />Business Name and Location Address <br />Tax3syer Name and Mailing Address <br />1 <br />MIGUEL TERCERO BAUTISTA <br />PO BOX 364 <br />GRAND ISLAND NE 68601 <br />Tax Years 2010 <br />(ICC Instrument Number 99147352010 County instrument Number 201402689 <br />Type of Action <br />® Continuation of Tax This is a continuation of en existing lien and serves to continue the lien and priority of the Nebraska Department of Revenue <br />Lien for an additional 10 years. <br />I hereby candy that Si. Nebraska Department of Revenue has complied with the laws of the Slate of Nebraska in determination of the <br />continuation, terrtknation, partial release, or subordination Indicated above. <br />Sa4a, Revenue Agent 11/15/2023 (308)632-1208 <br />(Preparers Signature //ff Tile Dale Phan Number <br />sara.holliday@nebraska.gov <br />Email Address <br />e�!1 it/ee Qd Revenue Supervisor 11/15/2023 <br />Authorized Signature Tab Dale <br />4432-1965 floc Sante <br />9opersedse 4.232.1968 Raw 1.2013 <br />