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State of Nebraska 5/8/2019 3:36:26 PM PAGE 5/008 Fax Server <br />N.E1 A -S 4 ; / <br />NE Ser el Stute - Robert. B Evnen <br />Ftlnng Document # 1 9 050 005 75-2 Pages 1 <br />llebtei Name DEREK: L b:ERMOADE <br />Filuµ. Date 31 IJTun e 05P952019 01 53 PM <br />Notice of State Tax Lien <br />This Notice of State Tax Len is isieued by the Nebraska, <br />Department of Revenue for unpaid taxes a:trninietered by the Tax <br />Commissioner: Taxes, incIuding penalties, interest. and costs, <br />which are ssho;m n below, are due from the taxpayer and remain <br />unpaid after dernand.Theae taxes are a lien for all property located <br />in the county and rights to property awned by the taxpayer or <br />acquired before the expiraso;a of this lien. Thio lien will expire and <br />become unenforceable 10 years after the dale of recordinr,, if rio <br />continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />407'10998 <br />,t,n <br />11 928036 <br />r€GI Lti <br />April 30, 2019 <br />201902644 <br />PLEASE RETURN FO <br />N fil .�St:A DEPT Of- REVENUE <br />1)0 BOX 94:SCm i <br />DNCOLN NE:68SC3-46O9 <br />P LEAD E Dee Prot Mil 5.N THIS 5RAC <br />XXX -XX -3212 <br />XXX -XX -7688 <br />HALL <br />Business ie and Leucaction Address Taxpayer Nrm"nu and Mailing Addrvca <br />3x oor r i <br />DEREK L iSE-F:tglOADE <br />L. sUkA L ZR10K <br />11244 5 PINE ST <br />GRANO ISLAND NE, 58801 <br />Tax Period <br />individual <br />20'-; <br />Date of <br />Assessment <br />$7:18.00 ] S25.40 <br />11tO'CSt <br />Casts Total Due <br />52t 0 <br />sign <br />here <br />635.44 <br />Toisl SS835.44 <br />. T r^aa n - rt it." .J s r rS,1,I a�.. ,,,r: - r.. ..., . 5.r: ,,n. N: : <br />v:Cl,: rl IC..• I , .)'! ` ...tit :. :=J'.:' .. ,1.... Ck 5.S: (.t.-.:�C T.. �F_. .�• (:1 J:,t 'J... P( ,5 .: 1::: r•]; .-1 h s ., S.,0,".:011,,-. v kg;.; <br />1:,vs::rrti =:I ::n): ...;J i:: 1•'in :;+:(Jw`: v:-.., <br />Re eri,_sAC1 flt 045.:05.2019 00e)S32-1203 <br />17,,k t'a,!. <br />Revenue Supervi5o; 0413.Y20S9 <br />�o.. ........ .....�.._,....., ..:.t•5.>_ :.,.. _..� <br />