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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 />Individual <br />2012 <br />04/25/2016 <br />$295.00 <br />$14.75 <br />$39.98 <br />• Corrected <br />349.73 <br />Total <br />$349.73 <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 demend.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 />PLEASE DO NOTWRITE INTHIS SPACE <br />Nebraska II) Number <br />95434550 <br />Federal ID Number <br />Lien Serial Number <br />11796046 <br />Uen Filed With: <br />® Register of Deeds • County Clerk <br />Social Security Number <br />XXX-XX-6493 <br />Spouse's Social Security Number <br />XXX -XX -8266 <br />dale of Lien <br />October 20, 2017 <br />Lien lyric: <br />County <br />HALL <br />Kg original ■ Continuation <br />• Corrected <br />Oct. 23. 2517 2:55PN NE Secretary of State — UCC <br />Nebraska Department of <br />REVENUE <br />sig <br />here <br />Business Name and Location Address <br />I certify <br />at the <br />tea in <br />thorized Signature Title <br />201707195 <br />Notice of State Tax Lien <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />NE sec of same John <br />Taxpayer Name and AAeilin <br />SHANDA I HAMNER <br />TREVOR V POPE <br />217 WEST 19TH ST <br />GRAND ISLAND NE 68801 <br />No. 2360 F. 3 <br />A axl - <br />Address <br />v <br />UCC ST <br />9917800315 -7 <br />HRIINER SHNNDR I <br />Filed: 10/n/2017 10.26 AM <br />Faa <br />Nebraska Department of Revenue has complied with the laws of the State 01 Nebraska in determining the amount shown to be due. <br />has failed to pay the amount due after demand. This Notice of State Tax Lien is an effective lien and serves to continue the priority of <br />the affected property of the taxpayer. <br />10/20/2017 (402)471 -5731 <br />Date Phone Number <br />10/20/2017 <br />Date <br />4.494 - 1974 Rev. 8 -2013 Supersedes 4- 948-1974 Rev. 2.2002 <br />A\f/ <br />