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State of Nebraska 6/28/2019 3:08:20 PM PAGE 3/004 Fax Server <br />20190378R <br />rfs.lEB-R-At-S-KA- <br />NE S rc of State - Robert B Evnen <br />Filing Document 4: 1906001355-6 Pages: 1 <br />Debtor NunABDULKADER ?MOHAMED <br />Filing Date 3nd Tune- 0612S/2019 11 IS AM <br />Notice of State Tax Lien <br />This Notice of 'State Tax Lien is esued 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 atter 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 />91756279 <br />t XI!! <br />11931931 <br />PLEASE., DO NOT WRITE IN TM SPACE <br />10 <br />SIXIN -tivxur-LL, <br />XXX -XX. -9838 <br />June 21, 2019 1 X eLcotiqual,r: 11] •-::A <br />1 ti6iness Name and Location Addres <br />sS.eiie.771; <br />HALL <br />Taxpayer Name and Mailing Address <br />El DULKADIR .J MOHAMED <br />522 SUTHERLAND STREET APT 3 <br />GRAND ISLAND NE 58801 <br />Tax Program <br />Tax Period <br />Dae ofTar. <br />Assessment <br />nrJividua <br />2017 <br />02/ 1r2018 <br />Penalty <br />S42.25 <br />interes1 I Costs <br />$37.971 <br />Total Due <br />925.22 <br />Totai„. S925.22 <br />CA --Si. thC. Z. CS tv:Zr.r..0 'AIN:. of Si;, F.LtN zgi , SIAZ. <br />1,.at 15'A 1‘11.1, Z.k,,N1.11.i cz.nt4,, <br />ir:€,,rus; <br />sign • <br />here r <br />. • <br />Revenue Agent <br />Revenue Supervisor <br />C1E421/2019 002i471-5713 <br />t.;401Alt. <br />OiS121/2016 <br />