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, <br />o% <br />NE Sec of State - Robert R. Evnen <br />Filing Document #: 2002000139-3 Pages: 1 <br />Debtor Name: FARHIYA ARDINASIR OMAR <br />Filing Date and Time: 02/04/2020 11:39 AM <br />Notice of State Tax Lien <br />This Notice of State Tax Lien is !sued 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 ail 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 1O 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 />202000835 <br />PLEASE DO NOT WRITE IN THIS. SPACE <br />`3eteicka 03 Kammer <br />10167226 <br />Feoe.ai U Nownef . .1T� <br />ra <br />Eon. Se'.S te::,•_do. <br />12046779 <br />:;ate a Lot <br />January 20, 2020 <br />Lan Find Writ <br />009.000 91 ,'Janna <br />Um Typo; <br />Sonat Sscsrty Kama.: <br />rycw•. ` XXX -XX -9968 <br />Carnrcoat»n []ce.,Ca:i..x <br />:,cony <br />RAIL <br />Business Name and Location Add <br />Taxpayer Name and Nailing Address <br />FARHIYA ARI)INASIR OMAR <br />AFRICAN GROCERY STORE <br />904\POPLAR ST APT 4 <br />GRAN!) ISLAND NE 6k*01 <br />Tax Program <br />tae Period <br />Date of <br />Assessment <br />Tax <br />lena?ty <br />Interest <br />Coals <br />Total Due <br />Sates <br />107,01;2017 -09%10+2017 <br />W11:2019 j <br />650 001 <br />130 00 i <br />57.6:, <br />00 <br />S.i7.63 <br />Sales <br />:10.01:2{117- 121.11,'2017 <br />11.11;2019 ei <br />650.001 <br />130.001 <br />52.71 <br />.00 <br />832.71 <br />Sates <br />' OLO1/2018 - 01!31/2018 <br />11£11;2019 i <br />650 00 <br />110 00 <br />47.90 <br />00 <br />82790 <br />Sales <br />04.01;20 18 - 0610,-1018 <br />11 11:2019 <br />[ <br />650 00 <br />130.00 { <br />43.04 <br />Saks <br />07,01;2018 - 09/30:2018 <br />11111,2019- <br />I <br />650 00' <br />11 00 <br />311.13 <br />Oil <br />818.13 <br />Salts, <br />10;012018 - 12;31;201S <br />11;11;2019 1 <br />65000' <br />130.00132.50 <br />00 <br />812.51) <br />Sales <br />01'012019-03 11x2019 <br />11.11x2019 <br />630.00" <br />110-00, <br />24,49 <br />.O9 <br />8(14.49 <br />Sates <br />04./0112019 - 06130-2019 <br />1 1 11.2019 <br />630,00 <br />130.00] <br />16.38 <br />AX) <br />79(1,38 <br />i'ntul <br />6,552.78 <br />sign <br />here <br />ec^ity 5t the riet,It L`arkrtn 0vd :a ^nenue roes emq:a,ed elan the Ion of e<r Mate ot NouMas-n deaern *t5 tut amouro aw... s, 00 3,0. <br />a,1 that t^e mc;rato has faAitl to pay the a -neat due atlo, 'M,4. ?tis Nenee el Stags sax Liens. an Comma Ian and O,,411 a onexve the pow*, 0. <br />the Stowe e eeeu inme ateaad reopen, pt the trapa,e.:. <br />• <br />Ret'enue Agent <br />tam <br />Revenue Senior Agent <br />01/13/2t)20 402.471-6067 <br />Tek! <br />Gate <br />pate <br />044'6 t: cooeiss 4,1144, ON. :t'M, 6.8:;t't <br />