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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 />2011 <br />04/13/2 <br />$837.00 <br />$209.25 <br />$167.26 <br />1,213.51 <br />Total <br />$1,213.51 <br />_Jun, 26. 2016 2:50FM NE Se c.r eta ry of State <br />201804088 <br />Nebreeke Department of <br />REVENUE <br />Nebraska ID Number <br />47900040 <br />Lien Serial Number <br />11808849 <br />Date of Llen <br />June 21,2018 <br />sign <br />here <br />Notice of State Tax Lien <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 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 />NE See of $4.4. dehn R Y.r. - UCC <br />PLEASE DO NOT WRITE IN THIS SPACE <br />County <br />HALL <br />LAURA HOBBS <br />5622 N QUANDT RD <br />GRAND ISLAND NE 68801 <br />., 021 F. 2'2 <br />9918814565 -4 <br />4OB13S LAURA <br />Filed: 06!2B/201e 10:47 <br />Pus: 1 <br />PM <br />PLEASE RETURN TO <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />Ti. <br />Lien Piled Wilk <br />Regislor of Deeds ❑ County Clerk <br />Federal ID Number <br />Social Wanly Number <br />XXX -XX -1256 <br />Lien Type: <br />® Original ❑ Continuation ❑ Corrected <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />Spouse's Social Security Number <br />1 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 failed to pay the amount due after demand. This Nolte of State Tax Lien le an effective lien and serves to continue the priority of <br />the SIale'a in - rest in the a 01 property of the taxpayer, <br />Revenue Agent 06/21/2018 (3081632 -1 <br />mile Date Phone Number <br />Revenue Supervisor 06/21/2018 <br />Title Date <br />4.494 -1974 Rev a -2013 guperaeoeo4a49.19'r4 Rev. 2 -200 <br />