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a)� <br />• PLEASE RETURN ORIGINAL TO " <br />COMP'.IANCE DIVISION <br />NEBRASKA DIRT OF REVENUE <br />PO 130X 94609 <br />LINCOLN, NE 68509 4609 <br />r_.fe. Gted: Swv:e <br />2020012'76 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2002001161-9 Pages: 1 <br />Debtor Name: MICHELLE KROGER <br />Filing Date and Time: 02/26/2020 09:45 AM <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 are a 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 N no <br />continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement <br />- <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />13212680 <br />Len Sena! Number <br />12049160 <br />Date of Len <br />February 20, 2020 <br />Len Fied With <br />Register of Deeds Ei County Clerk <br />Federal D Number. <br />NoFed Cm/ -Sol . prop ri��r' <br />Social Security Number use's Social Security Number <br />XXX -XX -2605 <br />Len Type: <br />® Orgmal DContinuation EDCorr <br />Business Name and Location Address <br />County <br />scrod HALL <br />Taxpayer Name and Mailing Address <br />MICI IELLE KROGER <br />DIVA RUSTIC SEAGULI. <br />3404 W I3TH STE 156 <br />GRAND ISLAND NE 68803-2383 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Saks <br />01/01/2018 - 09/30/2018 <br />03101/2019 <br />.00 <br />47.98 <br />94.60 <br />.00 <br />142.58 <br />Sales <br />10/01/2018 - 12/31/2018 <br />02'01/2019 <br />.00 <br />.00 <br />10.65 <br />20.00 <br />30.65 <br />Sales <br />01/01/2019 - 09/30/2019 <br />1 1:24/2019 <br />3,274.28 <br />339.001 99.33 <br />.00 <br />3,712.61 <br />Total <br />3,885.84 <br />sign <br />here <br />I certify that he Nebraska Department of Revenue Ras complied with the laws of the State of Nebraska in Oe ermning the amount shown b be due_ <br />and that the taapayer has failed to pay the amount due alas, demand. This Notice of State Tax Lien is an ellecove lion and sones to continue the priority o1 <br />tttR State's interest n he reeled property of the taxpayer. <br />Revenue Senior Agent 02/20/2020 308-535-8294 <br />Title Date Philtre Number <br />Revenue Supervisor 0f V1�I�1 t <br />Tide <br />Date <br />a-194.1974 ner, 0-20.8 Supe•eeoee 4-349.1973 saw. 8-70t3 <br />