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Tax Program Tel Period Assessment Tax Penalty Interest Costs Tote! Due Individual 2013 08/22/2014 367.00 25.20 32.97 425.17 Total $425.17 Oct, 24. 2016 2:24FM NE Secretary of State — UCC Nehraeks Department of REVENUE This Notice of State Tax Lien Is issued by the Nebraska Department of Revenue for unpaid taxes administered by the Tax Commissioner. Taxes, Including penalties, interest, and costs, which are shown below, are due from the taxpayer and remain unpaid after demand.These taxes are a Ilea for all property located in the county and rights to property owned by the taxpayer or acquired before the expiration of this Ilen.This lien will expire and become unenforceable 10 years after the date of recording If no continuation statement is recorded on or prior to the expiration of the previous lien or continuation statement. Nebraska ID Number 99360462 Lien Serial Number 11679297 Date of Lien 10/20/2016 sign here Business Name and Location Address zed Signature Lien Filed Wilk Register of feeds ❑ County Clerk Lien Type; Original 201607063 Notice of State Tax Lien Federal ID Number Social Security Number XXX -XX -6530 ❑ Continuation ❑ Corrected WHITNEY STONE TIMOTHY STONE 416 S EDDY ST GRAND ISLAND NE 68801 Na Cac nr 5f '.g .Yatn A PLEASE 00 NOT WHITE IN THIS SPACE V'.,. 3513 F. 2 9916781830 -9 5TONE WHITNEY Filed: 10!24/2018 09:64 AM Spouse's Social Security Namur XXX -XX -0217 County HALL Taxpayer Name and Mailing Address I certify that the Nebraska Department of Revenue has complied with the lane of the Slate of Nebraska In determining the amount shown to be due, and that the taxpayer has tailed to pay tha amount due alter demand. TNs Notice of State Tax lien is en effective Hen and serves 10 continue the priority 01 thee ate's interest In the ; fleeted property of the taxpayer. UCr STL ga: 1 Revenue Agent 101201201 110471 -6713 Title Date Phone Number Revenue Supervisor 10/20/2016 Title bate 4- 494 -1974 Hey. 9 3.ereesee 49-4&1971 Hey. 2 -2002