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(i xid iir!e_ Crest <br />e.w.erer«««Howe <br />NE Sec of State - Robert 13. Evncn <br />Filing Document #: 1912001110-6 Pages: 1 <br />Debtor Name: JOSHUA D STEPHENS <br />Filing Date and Time: 12/23/2019 08:28 AM <br />Notice of State Tax Lien <br />201908081 <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.Thesetaxes are a hen 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 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 WP TE IN THIS SPACE <br />PLEASE RETURN T0: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 34609 <br />LINCOLN NE 68509-4609 <br />Nebraska 10 Number <br />42889537 <br />federal ID Number <br />Lien Serial Number <br />11945823 <br />Len Filed With: <br />`1 ] Register of Deeds © county Clerk <br />Semi Security Number <br />XXX -XX -8346 <br />Spouse's Social Security Number <br />Dale of Lien <br />December 17, 2019 <br />Len Type: <br />® Original ❑Continuation ❑conaria <br />Gdunty <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />JOSHUA 0 STEPHENS <br />1903 WEST 16TH STREET <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 />2016 <br />05124/2017 <br />$199.00 <br />$9..95 <br />$19.79 <br />228.74 <br />Total <br />$228.74 <br />1 certify hat the Nebraska Department of Flevertue has cdmpeed with the laws of the Stab of Nebraska in 0eier ni g the amount shown b tae deet <br />and that the taxpayer has faced to pay the amount due after demand. This Notice of State Tax Len is an effective lien and serves to cantinas the priority of <br />the States interest in Ipe(proGerty <br />sign r''e� <br />here <br />Revenue Agent 12/17/2019 (308)632-1206 <br />Tyle Amb Phone Number <br />Revenue Supervisor 12/17/2019 <br />Tae <br />Date <br />ata 3a— n i rbv.. 41-et`t9 4:parsades beta r97a r1ax. a•7Ct3 <br />