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Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Litter Fee <br />07/01/2011 - 06/30/2014 <br />08/16/2015 <br />37.95 <br />66.61 <br />4.28 <br />.00 <br />108.84 <br />Sales <br />10/01/2013 - 10/31/2013 <br />08/16/2015 <br />.00 <br />111.78 <br />.18 <br />.00 <br />111.96 <br />Sales <br />03/01/2013 - 06/30/2013 <br />08/16/2015 <br />.00 <br />588.61 <br />3.77 <br />.00 <br />592.38 <br />Sales <br />05/01/2014 - 08/09/2014 <br />08/16t2015 <br />2,325.00 <br />579.75 <br />67,89 <br />.00 <br />2,972.64 <br />Withholding <br />01/01/2014 - 08/09/2014 <br />08/16/2015 <br />184.00 <br />93.40 <br />6.10 <br />.00 <br />283.50 <br />Withholding <br />01/01/2013 - 12/31/2013 <br />08/16/2015 <br />.00 <br />31.81 <br />1.17 <br />.00 <br />32.98 <br />Total <br />4,102.30 <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 alter 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 if no <br />continuation statement is recorded on or prior to the expiration of <br />the previous Hen or continuation statement. <br />PLEASE DO NOTWNITE INTHIS SPACE <br />. <br />Nebraska ID Number <br />8239665 <br />Federal 10 Number <br />391964386 <br />Lien Serial Number <br />11594065 <br />Lien Filed With: <br />Social Security Number <br />XX_XX-6064 <br />Spouse's Social Security Number <br />NI Register of Deeds ■ county Clerk <br />Data of Lien <br />August 16, 2015 <br />Lien Type; <br />• <br />® °n ow 0 Continuation []Corrected <br />County <br />HALL <br />Sep. 9. 2015 3:26PM <br />c_A <br />Nebraska Department of <br />REVENUE <br />Business Name and Location Address <br />E Secretary of State — UCC <br />sign -i <br />h ere Prepare Signature <br />C <br />au (nixed Signature Title <br />2015067' <br />Notice of State Tax Lien <br />Title <br />Revenue Senior Agent <br />Ni flee of 54.4. John A 6.1. - ULL STL <br />1 04- 1 <br />WI N RXGHAR29 5R PAS; D <br />Filed: 09/09/2015 09;51 AM <br />n <br />No. 2557 P. Ji`J <br />Taxpayer Name and Mailin <br />RICHARD D WISEMAN <br />103 BEACHWOOD DR <br />GRAND ISLAND NE 68803 <br />Address <br />I certify that the Nebraska Department of Revenue has complied with the laws of the Stale of Nebraska in determining the amount shown to be due. <br />and that the taxpayer has tailed to pay the un1 due aher demand. This Notice of Stale Tax Lien Is an effective lien and serves to continue the priority of <br />the S west in the affected props p a the taxpayer. <br />Revenue Agent 9/x'1_41/91.; 402 -471 -6067 <br />Dale Phone Number <br />Dale <br />4- 494.1874 Rev. 6-2019 Supersedes 4-949-'1974 Pee. 2-2002 <br />