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PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />N_Eoonsvn <br />G^od Lie. ;;,eat S+r ece <br />201903950 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 1907000396-5 Pages: 1 <br />Debtor Name. JAMES M MACHAR <br />Filing Date and Time: 07/08/2019 09:24 AM <br />UCC #: 99096154171 <br />Notice of State Tax Lien County Instr. #: 200910269 <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 Iien.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 />PLEASE DO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />99261502 <br />Lien Serial Number <br />10933783 <br />Dale o1 Lien <br />12/28/2009 <br />Federal D N,enber <br />Lien Filed With: <br />® Register o1 Deeds [_] County Clerk <br />Social Secunty Number <br />XXX -XX -9538 <br />Spouse's Social Security Number <br />Len Type: <br />EI Original XContinuation LlCorrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />JAMES M MAC HAR <br />311 3RD ST APR 21 <br />GRAND ISLAND NE 68801 <br />Tax <br />Program <br />Tax Period <br />ate of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2005 <br />03/25/2007 <br />112.00 <br />22.10 <br />98.98 <br />233.08 <br />Individual <br />2006 <br />03/24/2008 <br />132.00 <br />6.60 <br />24.62 <br />163.22 <br />/ <br />/7 e Total <br />$396.30 <br />sign <br />here <br />I certify <br />and that <br />the S <br />of Revenue has complied with the laws o1 the State of Nebraska in determining the amount shown to be due. <br />he amount due ater demand. This Notice of State Tax Lien is an effective lien and serves to continue the pnorhy of <br />1 the taxpayer. <br />ed <br />Taxpayer Services Specialist 11 07/01/2019 (308)632-1240 <br />Title <br />Revenue Supervisor <br />Date Phone Number <br />07/01/2019 <br />Title <br />Dale <br />4454.1874 Rew.8-2016 5 Wersedes 4.949..970 Rev. 8-2013 <br />