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NE A844A- <br />Gooc Life. Great Service. <br />oter.ell IR( <br />202306538 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2312000434-9 Pages: 1 <br />Debtor Name: MICHAEL L MEDBERY <br />Filing Date and Time: 12/15/2023 09:57 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 StateTax 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 />Nebraska ID Number f Federal ID Number <br />3500.3871 <br />Lien Serial Number Lien Filed Wlth <br />Please Do Not to In Thls Space <br />So SeCurtly Number <br />XXX -XX -5670 <br />Spousal Social Securely Number <br />11812782 I Secretary of State, Register of Meds <br />Date of Lien <br />08/23/2018 <br />Tax Program <br />22 <br />oaatfon Add <br />County <br />HALL <br />Taxpayer Name and Mailing Address <br />MICHAEL L MEDBERY <br />511 WALDO AVE <br />GRAND ISLAND NE 68803 <br />Tax Years 2015 <br />UCC Instrument Number 99188188969 <br />County instrument Number 201805831 <br />Type of Action <br />I$j Termination of Tax The State Tax Lien is hereby fully terminated. <br />Lien <br />1 hereby certly that the Nebrecke Department of Revenue ha* complied with the laws of the Stele et Nebraska in determination of the <br />continuation, terminatioe, partial release, or subordination Indicated above, <br />rfi� :414' 4Z4-77424&4 <br />R'eparedignature Revenue Agent 12/05/2023 (308)632-1210 <br />bridget.martin@anebraska.gov <br />Email Address <br />ate Phone Number <br />1 dd/E �B�id Revenue Supervisor 12/05/2023 <br />Autnorizad. Signature Ra <br />Date <br />4-232-196a Inv. 9.2019 <br />Supersedes 4-232.196e Rev. 14015 <br />