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NJERRA&KA- <br />(,ocd Life.:_r�., t Service <br />201906760 <br />NE Sec of State - Robert 13. Evnen <br />Filing Document #: 1910001680-2 Pages: 1 <br />Debtor Name: ZACIIARY L ZIERKE <br />Filing Date and Time: 10/29/2019 11:17 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 alt property Iocated <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 />PLEASE RETURN TO. <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />Nebraska ID Number <br />46699252 <br />Federal ID Number <br />Lien Serial Number <br />11942087 <br />Lien Feed With- <br />® Register of Deeds ❑ County Clerk <br />Social Security Number <br />XXX -XX -2978 <br />i Spouse's Social Security Number <br />Date of Lien <br />October 24, 2019 <br />Lien Type: <br />®OrgOef ❑Commuation ❑corrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />ZACHARY L ZIERKE <br />218 N LANE <br />GRAND ISLAND NE 68803 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2018 <br />05/07/2019 <br />$456.00 <br />522.80 <br />$11.99 <br />490.79 <br />Total <br />$490.79 <br />sign`" <br />here r <br />1 certay that the Nebraska Department of Revenue has complied with the laws of the State of Nebraskain determining the amount shown 40 be due. <br />and that the takpeyer has tailed to pay the /Omount due atter de -nand. This Notice of Stale Tax Lien is an effective Lan and serves to continue the priority of <br />the State's interest in the alfa eMfdrlhe ta <br />Revenue Agent <br />—itta <br />Revenue Supervisor <br />10/24/2019 (308)632-1206 <br />Date Phone Number <br />10/24/2019 <br />'de Date <br />a.aga.l g!a Res.. 8-2:aP 0ope edea 4.'349-1974 nev. 8-20,3 <br />