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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 />10/09/2017 <br />$495.00 <br />$24.75 <br />$27.54 <br />El original ❑Conllnualion <br />547.29 <br />Total <br />$547.29 <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 area 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 tlen.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 Ilen or continuation statement. <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />40835774 <br />Federal ID Number <br />Lien Serial Number <br />11802287 <br />Lien Filed With: <br />Social Security Number <br />XXX -XX -6838 <br />SpouSeS Social Security Number <br />f'7 Register of Deeds ■ County Clerk <br />Date of Lien <br />February 21, 2018 <br />Lien lope: <br />County <br />HALL <br />El original ❑Conllnualion <br />• Corrected <br />Feb. 26. 2018 3:35PM NE Secretary of State — UCC <br />OB <br />Ne braska Department of <br />REVENUE <br />sign <br />here <br />Business Name and Location Address <br />Signature <br />rized Signature <br />Notice of State Tax Lien <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />No. 3542 P. 2 <br />201801164 <br />NE sac of State. John A Gala - UCC 9TL <br />9918808701 -4 Ps=: 1, <br />WEEKLEY DEVEN <br />Filed. 02/2612019.12:69 PM <br />Taxpayer Name and Mailing Address <br />DEVEN WEEKLEY <br />518 EAST 7TH STREET <br />HASTINGS NE 68901 <br />1 ceflify that the NebrasKa Department Of Revenue has compiled with the Taws of the Stale of Nebraska in determining the amount shown to be due, <br />and that the taxpayer has failed t0 pay the amount due after demand. This Notice of State Tax Lien ie an effective Gen and serves to continue the priority at <br />ale's Interest i the affected ., arty of the taxpayer. <br />.:.1 <br />02/21 /2018 (402)471 -5713 <br />Oats Phone Number <br />02/21/2018 <br />Title Dale <br />4- 494 -1074 Rev. 0-2013 Supersedes 4.949 -1974 Rev. 2 -2 <br />