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Great 5.ew,ce. <br />I.R.1•1, .01T Cr analli•011 <br />202002294 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2004000643-9 Pages: 1 <br />Debtor Name: NICHOLAS WINFREY <br />Filing Date and Time: 04/15/2020 09:28 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 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 lien or continuation statement. <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Date of <br />Assessment <br />Nebraska ID Number <br />99731037 <br />Federal ID Number <br />Interest <br />Llen Serial Number <br />12052204 <br />Lien Filed Nfith: <br />® Register of Deeds ❑ County Clerk <br />Social Security Number <br />XXX -XX -7477 <br />Spouse's Social Security Number <br />XXX -XX -9615 <br />12/08/2017 <br />Dale of Lien <br />April 08, 2020 <br />Lien Type: <br />❑Corrected <br />County <br />HALL <br />1 <br />Li Original ❑Continuation <br />Busin <br />se Name and Location Address <br />m <br />axpayer Nae and Mailing Address <br />NICHOLAS WINFREY <br />SARAH WINFREY <br />102 W PARADISE LK <br />PHILLIPS NE 68865 <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 />2016 <br />12/08/2017 <br />$631.00 <br />$36.55 <br />$72.52 <br />740.07 <br />Total <br />$740.07 <br />sign <br />here <br />I certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska in determining the amount shown to be due. <br />and that the taxpayer has failed to pay the amount due after demand. This Notice of Slate Tax Lien is an effective ken and serves to continue the priority of <br />the State's interest in the affected properly of the taxpayer. <br />Revenue Agent 04/08/2020 (308)632-1203 <br />itte Date phone Number <br />Revenue Supervisor 04/08/2020 <br />Title <br />Dale <br />4.43.1.1974 Rev. 6-2010 Supersedes .1-949.1974 Rey 9-2013 <br />