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Tax <br />Program <br />Tax Period <br />Dole at <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2012 <br />11/26/2013 <br />141.00 <br />37.05 <br />52.13 <br />830.18 <br />Individual <br />2013 <br />05/20/2014 <br />98.00 <br />4.90 <br />3.95 <br />106,85 <br />Total <br />$937.03 <br />.. Aug 24. 2015 2:28PM NE Secretary :t State — UCC <br />Nebra a Department o1 <br />REVENUE <br />This Notice of State Tax Lien Is Issued by the Nebraska <br />Department of Revenue for unpaid taxes administered by the Tax <br />Commissioner. Taxes, including penalties, Interest, and costs, <br />which are shown below, are due from the taxpayer and remain <br />unpaid after demand.These taxes are a lien for all property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this lien.This lien will expire and <br />become unenforceable 10 years after the date of recording it no <br />continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />Nebraska ID Number <br />96410019 <br />lien Serial Number <br />11556598 <br />Date of Lien <br />08/19/2015 <br />sign <br />h ere Preparers <br />Business Name and Location Address <br />nature <br />Authorized Signature <br />Notice of State Tax Lien <br />Lien Filed With: <br />® Register of Deeds 0 County Clerk <br />Lien Type: <br />Original <br />El Coniknladon <br />201505'763 <br />PLEASE DO NOT WRITE iNTHIS SPACE <br />Federal ID Number <br />The <br />Tide <br />PLEASE RETURN TO: <br />NEBRASKA DEPT or REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />Sodel Security Number <br />XX XX -8015 <br />0 Corrected <br />E See or 5t.te .onn A Gaits - UCC <br />II 1 <br />9915758776 -7 Pea: <br />NDUWt Y0 JOSHUA <br />Filed: an/24f2e16 01:47 PM <br />Spousela Social Security Number <br />County <br />HALL <br />Taxpayer Name and Mailing Address <br />NDUWAYO JOSHUA <br />616E DIVISION ST <br />GRAND ISLAND NE 68801 <br />l certify mat the Nebraska Department or Revenue has compiled with the laws of the State of Nebraska in determining the amount shown to be due, <br />and that the taxpayer has fall.. . I = r. - aunt due after demand. This Notice of Stale Tax lien fa an effective lien and serves to Continue the priority of <br />the State's Interest in t : . • I . Ply o the r. <br />411 11110 1 t.tm:. __� _ Revenue Agent <br />08119/2015 <br />Date <br />Nc. 2355 P. <br />TL <br />3080632 -1206 . <br />Phone Number <br />08/1912015 <br />Dale <br />4400071 Pita. 8-2012 supersertee 444E0974 Per. 2 -2002 <br />