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08 <br />NIEBRAsKA- <br />;/cod L fo Great Service. <br />N00nte n IN *NEWS <br />NE Sec of State - Robert R. Evnen <br />Filing Document #: 2002000137-5 Pages: 1 <br />Debtor Name: JON J OSTERMEIER <br />Filing Date and Time: 02/04/2020 11:35 AM <br />Notice of State Tax Lien <br />000834 <br />This Notice of State Tax Lien is issued by the Nebraska <br />Department at 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 ken 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 />NtlbtaaRa: to Number <br />9000593 <br />Federal RD NunGer.......... <br />8rpotkse's S4acial Security Number <br />Lien Serial Number <br />11945795 <br />lien Feed With <br />Social Sec0My Number <br />XXX -XX -5078 <br />ri Rosi+star of Deeds • Cou ty caerk <br />Data tN i en <br />December 23, 2019 <br />lien Type: <br />❑Corrected <br />Courtly <br />HALL <br />DL Original $ Conarvaaon <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />JON J OSTERMEIER. <br />604 E YUND <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Sales <br />04/01/2017 - 06/30/2017 <br />07/0212018 <br />.00 <br />40.20 <br />10.41 <br />.00 <br />50.61 <br />Sales <br />07/01.2017 - 09/30/2017 <br />07/02/2018 <br />.00 <br />40.68 <br />7.46 <br />.00 <br />48.14 <br />Sales <br />10/01/2017 - 12/3112017 <br />07/02/2018 <br />.00 <br />33.39 <br />9.75 <br />.00 <br />43.14 <br />Sales <br />01/01/2018 - 03/31/2018 <br />01102/2019 <br />.00 <br />.00 <br />7.63 <br />.00 <br />7.63 <br />Sales <br />07/01/2018-09/30.2018 <br />11/12/2019 <br />172.38 <br />57.25 <br />26.20 <br />.00 <br />255.83 <br />Sales <br />10/01/2018 - 12/31/2018 <br />11/012019 <br />489.90 <br />48.99 <br />22.61 <br />.00 <br />561.50 <br />Total <br />966.85 <br />I cerlity that the Nebraska Department d Revenue has complied with the laws 04 the State of Nebraska in determining the amount shown to be aye. <br />and Ilial the taxpayer ruu tailed to pay the amount due after demand. This Notice el Sate Tax Lien is an eaective hen and serves to continue the priority of <br />the Stales iaillgest ii1 the •L;.•. property of the taxpayer. <br />here ('nap.rera r • r Jeikystm x, <br />Authorized S•gnawrle?1 JeJa <br />Revenue Senior Agent <br />12/16/2019 402-471-5709 <br />Title Date Ptron9 Numyar <br />Re <br />Tile <br />Dale <br />4.494.1974 h. 5-3015 Supersedes 4449-t974 Rev. 8-0013 <br />