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Tax <br />Program <br />Tax Period <br />Pate of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />individual <br />2010 <br />04/20/2013 <br />496.00 <br />60.70 <br />' 180.94 <br />737.84 <br />Total <br />$737.64 <br />'Dec. 28. 2115 3:52PM NE Secretary of State — UCC <br />Nebraska Department of <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 if 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 />41503368 <br />lien Serial Number <br />11562899 <br />Dale of Lien <br />12/23/2015 <br />sign <br />here <br />Prepare <br />ed <br />5 <br />201508769 <br />Notice of State Tax Lien <br />Federal ID Number <br />Title " <br />Ne '5 ee',f 1 a4e John A 6a1Q - ICC STL• <br />1111 11 <br />9915765786 -5 ?ss:. <br />VOSS COLLEEN A <br />Filed: 12/2e/2e15 51:57 PM <br />PLEASE DO NOT WRITE INTHIS SPACE <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />Uen Hiedvu1N: <br />Register of Deeds 0 County Cleric <br />Social Security Number <br />X0X -XX -0062 <br />lien Type: <br />Chiglnal <br />0 Continuation <br />0 Corrected <br />Business Name and Location Address <br />Taxi y er Name and Mill Address <br />COLLEEN A VOSS <br />9506SNEHWY11 <br />WOOD RIVER NE 68883 <br />Spouse's Social Security Number <br />County <br />HALL <br />Nc:.4295 P. <br />I certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska M determining the amount ahown to be due, <br />' and Mal the taxpayer has failed to pay the amen! due alter demand. This Notice of Stale Tax Uen Is an effective Ilen and serves lo continue the priority of <br />the•Stete s interest in Me affected pr. • • rty of the taxpayer. • <br />. Revenue Ag 12/23/2015 (300)632 -1203 <br />Title Dale Phone Number <br />Revenue Supervisor 12/23/2015 <br />Data <br />4 -494 -1974 Rev. e-2013 SupNaedes 4.949.19/4 Rev. 2-2002 <br />