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Go.:1 lite. 1:"•ae'. Se�v��'v. <br />NE Sec of State - Robert R. Evnen <br />Filing Document #: 1912001231-8 Pages: 1 <br />Debtor Name: TIMMY R HELMS <br />Filing Date and Time: 12/26/2019 10:02 AM <br />201908139 <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <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 area 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 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 Tien or continuation statement. <br />PLEASE DO NOT WRITE IN THIS SPACE <br />etxa a ID Nu:nbe+ <br />48420751 <br />Fcdern110 Num4er <br />Lien Setter hutnber <br />11945950 <br />L Filed With; <br />[ Register of Deede[minty cry <br />Soei01 aacurny Number <br />XXX -XX -0214 <br />Spouses Sptial Sepurny Nut50g+ <br />Dale of Lien <br />December 20, 2019 <br />I., Type: <br />-.. <br />❑ca rays <br />County <br />HALL <br />® 0,g6t t ■ Co onuatwn <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />JIMMY R HELMS <br />707 W LOUISE ST <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Irttere+st <br />Costs <br />Total Due <br />Individual <br />2012 <br />06/07/2019 <br />$1,426.84 <br />0463.50 <br />$404.49 <br />2,294.83 <br />Individual <br />2013 <br />06/07/2019 <br />$1,773.00 <br />0443.25 <br />0336.78 <br />2,553.03 <br />Individual <br />2014 <br />06/07/2019 <br />01,824.00 <br />$456.00 <br />$291.74 <br />2,571.74 <br />Individual <br />2015 <br />06/07/2019 <br />$730,68 <br />0441,50 <br />$222.54 <br />1,394.72 <br />Individual <br />2016 <br />06/07/2019 <br />$2,132.00 <br />$533.00 <br />0212.91 <br />2,877.91 <br />Individual <br />2017 <br />06107/2019 <br />02,678.00 <br />$669.50 <br />'S187.10 <br />3.534.60 <br />Total <br />$15,226.83 <br />sign <br />here <br />1 certify that the Nebraska Department of Revenue hem cornpfed with the taws of the State of Nebraska In determining the amount shown to be due. <br />and that the taxpayer has hied to pay to amount due after demand, TN* Notice of Stan Tax Len a an aeeetree Tien and serves to continue the priority of <br />the Stab's irerest it the alleged propel of the tae s w. <br />Revenue Agent 12/20/2019 (308)632-1203 <br />?ele Date Phone Number <br />Revenue Supervisor 12/20/2019 <br />Witte Date <br />4.494 4974 Den, 920'5 sedes a -0a9-10 1 neve-2013 <br />