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Tax <br />Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2014 <br />03/2112016 <br />381.00 <br />19.05 <br />16.44 <br />416.49 <br />Total <br />$416.49 <br />Sep, 27. 2016 3:22FM NE Secretary of State — UCC Na,p�p V1 JJ F. 2 <br />A sal,. - uGG sn. <br />gB16780471 -0 Poi: 1 <br />Filed; 09 / 27 //2016 D 111 :14 AM <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.Thesetaxes 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 (ien.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 />93884567 <br />Lien Serial Number <br />11877608 <br />uen Fled With: <br />© Register of Deeds ❑ Courtly Clerk <br />Date of Llen Lien Type: <br />09/2112016 ® Original ❑ Conlinuarwn <br />Business Name and Location Address <br />sign <br />here <br />'4oi6O64O9 <br />Notice of State Tax Lien <br />Title <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Federal D Nurnber <br />Social Security Number <br />XXX -XX -1818 <br />Revenue Agent <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />Spouse's Social Security Number <br />County <br />❑ Corrected HALL <br />Taxpayer Name and Mailing Address <br />ABDELKADER ABDULLAHI <br />324 W KOENIG STREET APT 19 <br />GRAND ISLAND NE 68801 <br />t certify that the Nebraska Department of Revenue has compiled with the laws of the Slate of Nebraska In determining the amount shown 10 be due, <br />and that the taxpayer has failed to pay the amount due arler demand. This Notice of State Tax Lien is an !elective lien and serves to cormnue the pttotlly of <br />the State's interest In th alleote • prope . the taxpayer. <br />4 <br />Fro' ' <br />0912112016 (308)632 -1203 <br />Title Date Phone Number <br />Revenue Supervisor 09/21/2016 <br />Dare <br />4-494-1974 Rev, 6-2013 Supersedes 4-949-1974 Rev. 2-2002 <br />