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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 />2017 <br />06/08/2010 <br />$482.00 <br />Silted $6.43 <br />523.03 <br />Total <br />. ,;k23.03, <br />Sep. 24.2013 20FM NE S cretary of Stat_ 2018.06264 2 <br />PLEASE RETURN T0: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />Good Life 6nhe Serrlce <br />sign <br />here <br />find the <br />a,e 5 <br />N A:MUM <br />Notice of State Tax Lien <br />This Notice of State Tax Lien Is IBSued by the Nebraska <br />Department of Hevenue for unpaid taxes administered by the Tax <br />Comriilesioner. Tama, Including penattles, interest, and .costs, <br />which are ehovrn below, are due from the taxpayer and remain <br />un aid after demand.These taxes are a den for all property located <br />` lri Pier ` -ght €. to prop r WrzatI trrtftriaxitafer er <br />ecqulred kieiore the expiration of this ileit.Th1s'Ilefi NrilFeiCPlttirand <br />beauine unenforceable to year after the date of recording if no <br />continuation statement is recorded on or prior to the expiration 01 <br />the previous pen or continuation statement. <br />Nelueer,e ID Number <br />93083408 <br />Berta Nudiber Lbn Plied WIGS: <br />11814654 ® gy m Deeds 11 cum/ clear <br />pate of Lien thin Typo! <br />September 21,, 2018 - -Inmistny - Dccminueooa <br />Uueilteaa Noma acid Location Address <br />PLEAS <br />Federal 10 Numbs( <br />aec+r Stemily Number <br />XXX XX.6 8 . <br />171 ,Corteated <br />N5 Sec of Stale - John A. Oslo <br />Filing D)eurY,cnr/: 1869666:52 - 1 Popes: 1. <br />Debtor Name: ABDERISAQ MOHAMED AJ.I <br />Fieng Date 3id 'r,mc 09,241201a 61:46 PM <br />pp NOT WRITE IN THIS SPACE <br />.. T. . ,m, <br />Soousek Segal 5oaaty Number <br />County <br />HALL <br />Taxpayer Nanme and !Wallin t Address <br />ABDIRISAQ MOHAMED ALI <br />311 N LINCOLN AVE APT 8A <br />GRAND ISLAND NE 69601 <br />Deparlir d fteyonuo hes rofipllea sera, Ina laws d the Stele of Nobro9le'In deemp np Me owed r1UiMt to be duo. <br />pay the amount duo ever clottooncl. This Notion alas* VC Ugn bt an ofloottlb WA atm.'s to &NAVA (fie On(012Tht <br />led p opedy 01 the ASR <br />Revenue Agent 09(2112018 _(3131632-121O <br />1>� Dolo Mere r <br />R.evenue Supervisor 092112016 <br />No Dole <br />4491.1914 h!r. Rome stomata= 4 JI9.1a74 Nwa &4014 <br />