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NE Sec of State - Robert B. Evnen <br />Filing Document #: 2006000618-1 Pages: I <br />Debtor Name: CODY D NEZ <br />Filing Date and Time: 06/15/2020 08:56 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 it 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 />202003978 <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />braska t0 Num <br />39157865 <br />Federa <br />ID N <br />,r. Serial Num <br />12056169 <br />'Ott Filed WOO: <br />ILLS Register of Do <br />County Clea <br />Social Sec rIty Nath <br />XXX -XX -6865 <br />Spouses Sec at S95urily Number <br />Dam 01 <br />r <br />June 08, 2020 J Original 0 Continuation 0Co'xefed <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />CODY 0 NEZ <br />107 E 7TH ST APT A <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period <br />T <br />Date of <br />Assessment <br />Tax 1 <br />Penalty <br />Interest ? <br />I <br />Costs <br />Total Due <br />Individual i 2018 <br />05/07/2019 <br />$490.00 <br />$24.50 <br />$28.191 <br />542.69 <br />Total <br />$542.69' <br />sign <br />here <br />1 certity 13101 Ine. docraska Department or Revenue has compiled wit, too laws 01 Re Sate 01 Neraresxa determining the* amount showy: to he due, <br />arta t^al Fre laspmye os 'ailed 10 pay the amount due after demand. This Nritice o1 Slate Tay Lien, is an effective lien and serves to continue the rsiolily of <br />the States interest in t 100 prop 1 ty of Oce taxpayer, <br />_Revenue Agent 06/08/2020 _1301632-1210 <br />Y;tle Cane Phone Number <br />Revenue Supervisor 06/08/2020 <br />Date <br />ry.xga-tyrire . e 2a'a Srcwraa e3 d-y<p-'.$)-0 rias. 821111 <br />