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Orl <br />0 <br />QOA�vn <br />_..�-.-r-_rrcry-. <br />3c.xi c re. a_•rca. Sernux. <br />es,ax,mx, or xeverur <br />202005264 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2007000978-9 Pages: 1 <br />Debtor Name: JOEL A TUXHORN <br />Filing Date and Time: 07/23/2020 10:52 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 ere 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 DO NOT WRITE IN THIS SPACE <br />Nebraska 10 Number <br />12465771 <br />Federal ID Number <br />811187535 <br />Lien Serial Number <br />12056337 <br />Lien Feed With <br />Social Security Number <br />XXX -XX -7828 <br />Spouses Social Security Number <br />i7 Register of Deeds f County Clerk <br />Date of Lien <br />June 18, 2020 <br />Lien Type: <br />0Corrected <br />County <br />HALL <br />Kg Original , Continuation <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />JOEL A TUXHORN <br />317W4TH ST <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 />05/01/2018- 12/31/2019 <br />04'202020 <br />13,702.80 <br />3,443.48 <br />1,213.64 <br />.00 <br />18,359.92 <br />Withholding <br />04/01/2018-06/3012018 <br />04/20/2020 <br />50.15 <br />113.00 <br />10.09 <br />.00 <br />173.24 <br />Withholding <br />07/01/2018 - 09/30/2018 <br />04/20/2020 <br />644.34 <br />128.87 <br />50.44 <br />.00 <br />823.65 <br />Withholding <br />10/01!2018- 12/31/2018 <br />04/202020 <br />550.98 <br />27.55 <br />38.02 <br />.00 <br />616.55 <br />Total <br />19,973.36 <br />I certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska in determining the arnouM shown to be duo. <br />and that the taxpayer has tailed to pay the amount due alter demand. This Notice of State Tax Lien is an effective lien and serves to continue Inc pnonty of <br />thtelIe's interest-. :: fleeted property of the taxpayer. <br />`IL <br />sign4a0N ) Revenue Senior Agent <br />here' Prepare( ure "j Title <br />• . .��,��rlJ Revenue Senior Agent <br />Authorized Stg r fr Title Date <br />06/10/2020 402-471-5709 <br />Date Phone Number <br />7//7/2_02.o <br />4-4941974 lir. 92018 Supersedaa 4-949.1974 Rev 8.2013 <br />