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201905676
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9/13/2019 4:09:22 PM
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9/13/2019 4:01:20 PM
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DEEDS
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201905676
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N EFA <br />flood Life. Grca: Se<vice. <br />201905676 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 1909000637-7 Pages: 1 <br />Debtor Name: RANDALL KOWALSKI ESTATE <br />Filing Date and Time: 09/13/2019 10.27 AM <br />Notice of State Tax Lien <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 />12945412 <br />Federal ID Number <br />826220847 <br />Lien Serial Number <br />11936787 <br />Lien Filed With: <br />K, Register of Deeds ❑ County Clerk <br />Social Security Number <br />Spouses Social Security Number <br />Date of Lion <br />September 4, 2019 <br />Lien Type: <br />C Original ❑Continuation ci Corrected <br />County <br />IIAL1. <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />RANDALL KOWALSKI ESTATE <br />266 A RD <br />GRAND ISLAND NE 68801 <br />Fax Program <br />ran Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Fiduciary <br />03/01/2016 - 02/28/2017 <br />05/17/2019 <br />1,730.00 <br />432.50 <br />138.73 <br />.00 <br />2,301.23 <br />Total <br />2,301.23 <br />1 certdy that :he Nebraska Department of Revenue has complied with the laws of the State of Nebraska In determining the amount shown to be due, <br />and that the taxpayer has tailed to pay the amount due after demand. This Notice of State Tax lien is an affective hen and serves to contexto the priority of <br />the State's interest in Pre affected Properly of the taxpayer. <br />' <br />sign, • r�(k 'jf Revenue Agent <br />here Preparer's Si <br />Authorised Signature <br />08/28/2019 402-471-6067 <br />Title <br />rt/s Revenue Supervisor <br />Title <br />Dale <br />Phone um <br />'TMi�if <br />Date <br />a.494.197a Rev. 8.2018 Stn, e+srdea a.949•t974 Pee.. 64013 <br />
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