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N.EBR <br />Cren.. Litr.ioteritSer, r. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2005000885-2 Pages: 1 <br />Debtor Name: DANIEL D HARP <br />Filing Date and Time: 05/27/2020 09:47 AM <br />Notice of State Tax Lien <br />20200341] <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 lights 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 />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />Nebraska lb napriber <br />97607851 <br />Federal D Number <br />Lien Serial Number <br />12054941 <br />Len Fried With: <br />t] Register of Deeds - County Cie, <br />Sonat Secur,ts Norm aK <br />XXX -XX -8898 <br />Spouses Social Security number <br />Date of Lien <br />May 19, 2020 <br />Leen Type <br />(XI Orlgrnat 0Continuation 0Correcred <br />Coonty <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />DANIEL D HARP <br />315 E PHOENIX AVE <br />GRAND ISLAND NE 68801 <br />Tax Program <br />j <br />Tax Period <br />Date of <br />Assessment <br />Tax ? <br />$125.00' <br />Penalty <br />$31.25 <br />$21.95' <br />Interest <br />$11.32 <br />$24.05 <br />Costs <br />Total Due <br />167.57i <br />485.00 <br />Individual <br />2017 <br />i <br />10/30/2019 ' <br />Individual <br />2018 <br />1 <br />10/30/2019 <br />5439.00. <br />Total: <br />$652.57 <br />I certify that Rte Nebraska Depaartment of Revenue has complied with the laws or the State or Nebraska in determining the amount shown to be .due. <br />and that the taxpayer has is led to pay the amount due after demand, This Natrce et State Tax Lien to an effecttve igen bed serves to Contn-.e the priority of <br />the Slate's Interest ir,1 the a. ,_:. operry l the taxpayer. <br />sign <br />here Prapardr$ ire <br />autnorrze,j Si rraium <br />Revenue <br />Title <br />Revenue Supervisor <br />(308)632-1203 <br />Phone Number <br />05/19/2020 <br />n9c Date <br />4-494-r97t hey. 11-2'.'a Suetrsedee a.949-r9Ta Re,. 5.2C 3 <br />