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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 />IMMIIIINM <br />01/01/2014- 12/31/2014 <br />01/01/2015 - 12/31/2015 <br />01/01/2016 - 12/31/2016 <br />08/11/2015 <br />.00 <br />60.43 <br />11.05 <br />.00 <br />71.48 <br />08/09/20I6 <br />.00 <br />31.03 <br />.00 <br />205.61 <br />04/03/20I7 <br />.00 <br />25.41 <br />1.32 <br />.00 <br />26.73 <br />Withholding <br />01/01/2014 - 12/31/2014 <br />08/11 /2015 <br />.00 <br />149.50 <br />.00 <br />.00 <br />149.50 <br />Total <br />453.32 <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 Iien.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 />PLEASE DO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />11928263 <br />Federal 10 Number <br />460668585 <br />Lien Serial Number <br />13 788560 <br />Lien Flied With; <br />® Register of Deeds L_! Count Cierk <br />Social Security Number <br />XXX -XX -1735 <br />Spouse's Social Security Number <br />Date of Llen <br />June 2, 2017 <br />Lien Type: <br />D Corrected <br />County <br />HALL <br />13 Original 0 Continu <br />o' <br />Jun.15. 2017 4:21PM <br />Neoreake Department a <br />REVENUE <br />Notice of State Tax Lien <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />RICK S. DLJERJNG <br />PO BOX 99 <br />GRAND ISLAND NE 68802 <br />2 0114730 4 0 02g <br />Ng S o f S tate John S <br />9917793609 -a <br />DUERING RICK S. <br />Filed; 06/15/2017 10:34 AM <br />sign <br />here <br />I certify that the Nebraska Department I Revenue has complied with the laws of the State of Nebraska in determining the amount shown to be due, <br />and that • < taxpayer has tailed to pay I. aunt due after demand. This Notice of State Tax Lien is an effective Ilan and serves to continue the priority of <br />the nterestin the affected pro •._ 'I the taxpayer, <br />P. <br />t'reparsr'-'tg azure <br />Au <br />01120 Signature <br />Revenue Agent 06/12/2017 402- 471 -6067 <br />This Dais Phone Number <br />Revenue Senior Agent e ,i3 e7 <br />Title Dale <br />4 -484 -1974 Rev. B-2013 Superseese 4- 849.1974 Rev. <br />rD <br />