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Ns_BRA6 <br />610".1,«[+. o• •tv.w <br />202005262 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2007000980-4 Pages: 1 <br />Debtor Name: JON 1 OSTERMEIER <br />Filing Date and Time: 07/23/2020 10:55 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 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 />Nebraska ID Number <br />9000593 <br />Federal ID Number <br />Lien Ser al Number <br />12056970 <br />Lien Filed With <br />Social Security Number <br />XXX -XX -5078 <br />Spouse's Social Security Number <br />Eq Register of Deeds 0 County Clerk <br />Date of Lien <br />July 1, 2020 <br />Lien Type: <br />.00 <br />40.20 <br />County <br />HALL <br />© Original I Continuation <br />$ Corrected <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />JON 1 OSTERMEIER <br />604 E YUND <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 />Sales <br />04/0I /2017 - 06/30/2017 <br />07/02/2018 <br />.00 <br />40.20 <br />10.41 <br />.00 <br />50.61 <br />Sales <br />07./01 /2017 - 09/30/2017 <br />07/02/2018 <br />.00 <br />40.68 <br />7.46 <br />.00 <br />48.14 <br />Sales <br />10/01/2017 - 12/3112017 <br />07/0212018 <br />.00 <br />33.39 <br />9.75 <br />.00 <br />43.14 <br />Sales <br />01/0112018 - 03/31/2018 <br />01102/2019 <br />.00 <br />.00 <br />7.63 <br />.00 <br />7.63 <br />Sales <br />04/01/2018 - 06/30/2018 <br />04/01//2020 <br />562.79 <br />56.28 <br />49.83 <br />.00 <br />668.90 <br />Sales <br />07/01/2018 - 09/30/2018 <br />11! 1212019 <br />.00 <br />57.25 <br />27.62 <br />.00 <br />84.87 <br />Sales <br />10/01/2018 - 12/31/2018 <br />1110112019 <br />418.91 <br />48.99 <br />34.15 <br />.00 <br />502.05 <br />Sales <br />10/01/2018 - 09/30/2019 <br />11/0112019 <br />.00 <br />.00 <br />.31 <br />.00 <br />.31 <br />Sales <br />01./01/2019 - 12/31/2019 <br />03/02/2020 <br />.00 <br />.00 <br />9.89 <br />.00 <br />9.89 <br />Total <br />1,415.54 <br />sign <br />here <br />1 certify that the Nebraska Ocpanment of Revenue has complied with the laws of the State of Nebraska in determining the amount shown to be due, <br />and Oral the taxpayer has tailed to pay the amount due alcor demand. This Notice of State Tax Lien is an effective bon and serves to continue the priority of <br />the St +'s interest in t a tad property of the taxpayer. <br />Authorized <br />Revenue Senior Agent <br />Title <br />Revenue Senior Agent <br />06/24/2020 402-471-5709 <br />Dale <br />Tide <br />Phone Number <br />7//5/2- 2.0 <br />bate <br />4494-1974 qw. 62018 naperiedee 4-949.1974 Re. 84013 <br />