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L> <br />U <br />N-E.B17- <br />202001419 <br />NE Sec of State - Robert B. Evncn <br />Filing Document #: 2003000184-2 Pages: 1 <br />Debtor Name: YAHIA HASSAN <br />Filing Date and Time: 03/03/2020 11:12 AM <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 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 Iien.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 00 NOT WRITE IN THIS SPACE <br />Nebraska 10 Number <br />93060068 <br />Federal D Number <br />Lien Serial Number <br />12049861 <br />Lien Filed With: <br />Socull Security Number <br />XXX -XX -8321 <br />Spouse's Social Security Number <br />® Register 01 Deeds • Coumy Cler r <br />Dote of L en <br />February 27, 2020 <br />Lan Type: <br />®original El Continuation E] Corrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />YAHIA HASSAN <br />1416 W ANNA ST APT 3 <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 />Individual <br />2018 <br />05/07/2019 <br />$464.00 <br />$23.20 <br />$20.21 <br />507.41 <br />Total <br />$507.41 <br />sign <br />here <br />I certdy that the Nebraska Department of Revenue has compbed with Me laws of the State of Nebraska in determining the amount shown to bo due, <br />and (hal the taxpayer has failed to pay the amount due after demand. This Nonce of State Tax Lien is an effective lien and serves to continue the priority al <br />the State's interest In the affected properly of t119 taxpayer. <br />Revenue Agent 02/27/2020 (308)632-1203 <br />Title Date Phone Number <br />Revenue Supervisor 02/27/2020 <br />Tilt Date <br />a-404.1074 Rnv. 6-90+6 SuoRrxedaa a-949-1974 nw. 04013 <br />