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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 />2015 <br />05/24/2016 <br />$402.00 <br />$20.10 <br />$19.30 <br />►, original 0Continualio, <br />441.40 <br />Total <br />$441.40 <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 lien_ This Tien 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 00 NOT WRITE IN THIS SPACE <br />. <br />Nebraska ID Number <br />33691916 <br />Federal ID Number <br />Lien Serial Number <br />11797723 <br />Llen Filed With: <br />Social Security Number <br />XXX -XX -9001 <br />Spouses Social Security Number <br />17 Register of Deeds ■ County Clerk <br />Date of Lien <br />November 20, 2017 <br />Lien Type: <br />County <br />HALL <br />►, original 0Continualio, <br />III Corrected <br />Nov. 22. 2017 3:37PM NE Secretary of State — UCC <br />d <br />Nebraska Department of <br />REVENUE <br />I certify that the <br />at theta <br />te's Intere <br />the SI <br />sign <br />here Prep 7 a Signalare <br />Notice of State Tax Lien <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />No. 2654 F. 2 <br />201708044 <br />bi <br />C. of Skaka Jelin R Gal& - [1[e STL <br />i 1 <br />!I I li i�j II <br />� I!� Illi IC 10 <br />9917802001 -4 Psa: 1 <br />STAHLNECKER TRACY 5 <br />Filed: 11/22/2017 11:47 AM <br />TRACY S STAHLNECKER <br />2222 BELLWOOD DRIVE APT 29 <br />GRAND ISLAND NE 68801 <br />brasr Department of Revenue has complied with the laws of the Stale of Nebraska In determining the amount shown lo be due. <br />s 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 />affected property of the taxpayer. <br />11/20/2017 (402)471 -5731 <br />Dale Phone Number <br />11/20/2017 <br />Au horized Signature Title Dale <br />4-494 -1974 Rev. a -2013 Supersedes 4 -94e -1974 Rer.2 -2002 <br />