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201706884
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10/10/2017 4:19:43 PM
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10/10/2017 4:19:43 PM
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DEEDS
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201706884
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Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Llen Filed With: <br />Costs <br />Total Due <br />Individual <br />2011 <br />02/07/2015 <br />$110.99 <br />$18.20 <br />$51.09 <br />180.28 <br />Total <br />$1 80.28 <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 ail property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this llen.Thls 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 />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 <br />Nebraska ID Number <br />32116071 <br />Federal D Number <br />I-len Serial Number <br />11794982 <br />Llen Filed With: <br />Social Security Number <br />XXX -XX -5174 <br />.Spouses Social Security Number <br />ri Register of Deeds County Clerk <br />Date of Lien <br />October 03, 2017 <br />Lien Type: <br />Dcorrected <br />County <br />HALL <br />.1 Original Continuation <br />Oct. 10. 2017 3:48PM <br />Nebraska Department of <br />REVENUE <br />sign <br />here <br />Business Name and Location Address <br />I certify that the Nebraska Department of Revenue has Complied with the laws of the State of Nebraska in determining the amount shown to be due, <br />and that the taxpayer has fall . • - = the - • w due after demand. This Notice of State Tax Lien is an effective lien and serves to continue the priority of <br />the State's interest in the a : prop: r of the <br />Preparer'a Sure <br />" <br />Authorize ggnetu re <br />201 706884 <br />Notice of State Tax Lien <br />Revenue Agent 10/03/2017 (308)632 -1206 <br />Title Date Phone Number <br />Title <br />ANGELA S HANSON <br />1623 W KOENIG <br />GRAND ISLAND NE 68801 <br />No. 4299 P. 5/6 <br />NE See of 5iaie John A Gale - UGC STS <br />99177994840 Pgs: <br />HANSON ANGELA S <br />Filed; 10/1 012017 03;16 PM <br />Taxpayer Name and Mailing Address <br />10/03/2017 <br />Date <br />4 Rev. a- -2013 Supersedes 4.g49.1974 Rev, 2 - 200 <br />
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