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Mar. 13. 2019 2:24AV NE,.r.tary ::t Stat - 'JCC 20 1941.450 <br />G•aed Lite. Greer ser`ece. <br />NE Sec of Stale - Robert B. Evoea <br />Piling 'Document if: 1903000523-1 Pages: 1 <br />Debtor Name ANDREW K SAMUELSON <br />l: ;lira trate . ,d Tiac: 03/13/2019 11;20 AM <br />Notice of State Tax Lien <br />This Notice of Stale 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 costa, <br />which are shown below, ore due from the taxpayer and remain <br />unpaid afterdempnd.Theee 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.Thls lien will expire and <br />become unenforceable 10 years after the date of recording it no <br />continuation statement Is recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Neemcbt a3 herniae' <br />13169483 <br />Federal D Nang, <br />820766434 <br />Lien Serial Nlretel <br />11924952 <br />Lien Filed MIL <br />0 Aegean of Deeds ❑covey CITA <br />Becht sec./Thy Nurlttm <br />XXX -XX -9020 <br />5p0038 s SOCief Sew*I:y Minter <br />Dale of Len <br />March 6,2019 <br />Len Tjpe <br />®Ottonal 0ocn,nelian ❑Cnnecld <br />Camey <br />0A1,•l. <br />Business Name and Location Address <br />Taxpayer Nerne and Mailing Address <br />ANDREW k SAML'I3LSON <br />ROBOT RESALE <br />603 COLLEGE DR <br />DECORAH IA 52101 <br />Tax Program <br />-fax Period <br />Date of <br />Tax <br />Penelty <br />Interest <br />Costs <br />Total Due <br />Sale; <br />1.Assessment <br />01/01/2017 - 12/31/2017 <br />08;071:-'018 <br />610.00 <br />162.00 <br />30.17 <br />.0Q <br />1,002.17 <br />Total <br />1.002.17 <br />I echity eel the Nebraska DeperWbm 01 Roane', etas con,pl'ed mire re laws of me Sate of Nebraska in determeenc- the Mtau;tl BPD,, t 10 be Aue. <br />and tbal p,e la pey4, tai hoed to pay me Amount Out aber uerti rd. The hove Of Sate Tee Lien ll an ereothe lien and seteee to conll„ue the priority of <br />ee Stares (rarest In IM alleched properly of the l0006y0. <br />Sign ? 74/ <br />here, Pep. sSgraa. Ties Gaze aeonNumb <br />as Scliior AetnPhone <br />hoe um a <br />IrD,ROo argbab,ra roe Dale <br />..4N -197e aa. 5-20,0 Eupeeesec 4-p19 i0N fro , 6,--e13 <br />Revalue Alen t <br />03/08/2019 42-471-5717 <br />