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NEBRASKA <br />NE Sec of State - Robert A. Evnen <br />Filing Document #: 1911000412-5 Pages: 1 <br />Debtor Name: JAMES K KEESHAN <br />Filing Date and Time: 11/08/2019 08:59 AM <br />Notice of State Tax Lien <br />20190705E <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 arra Nonfat 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 after the date of recording if no <br />continuation statement is recorded on or prier to the expiration of <br />the previous Fen or continuation statement. <br />PLEASE 00 NOT WRITE W THIS SPACE <br />ve :asw xx t„.w • <br />24895385 <br />_axt Se -W B..mdar <br />11942237 <br />Say <br />October 25, 2019 <br />L_ <br />f.ted WW1: <br />1 an Tee: -,._.__...... ..- <br />J <br />N,e',bO, <br />XXX -XX -1420 <br />t I See ,tt ' c oo, <br />XXX -XX Q 9r3 <br />HALL <br />Business Name and location Address <br />Tax Program Tax Period <br />Individual <br />2012 <br />Individual <br />Individual <br />2013 <br />2014 <br />Date of <br />Assessment <br />08/11/2019 <br />08/11/2019 <br />08/11/2019 <br />Taxpayer Name and Melting Address <br />JAMES K KEESHAN <br />LORI EDWARDSON <br />605 N GREEN ST APT 5 <br />CLARKS NE 68628 <br />Tax <br />Penalty interest <br />571700 St 79 25i 515220 <br />5725.00, 5181.251 $132.151 <br />5411.00 5102.7 51 562.581 <br />Costs Total Due <br />1,048.45 <br />1.038 40 <br />Total <br />576.33 <br />$2,663.18 <br />sign <br />here <br />I r to I:ty !t a thio- Net: rnstw Itcpa•rrzwte'o 7tes9Aie lraa cemliwd *,r nw taws Of 00 st0 0 <br />or has L•49414, pay Ma a-ot et q;;w aM. *h ^'a,a7. Tk:a akcsce 5t $taa 110 I <br />1*ybayi i+n::+eriy ei 1,0 taspaydr.. <br />iii. <br />ale <br />Revenue Supervisor <br />a7r <br />w an r 4o,tn s n e <br />,, Revenue Agent 10/25/2019 <br />A..' m aed s.f'0.5 ,0 <br />(402)471_5713 <br />44x'q ham, <br />1012512019 <br />a 3,. •au 4.. 4 n, S FA... k.43.4.4. F3..&.50 <br />