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NEE <br />h:d t.ae tent Sr.c.. <br />2 <br />NE Sec of State - Robert B. Evncn <br />Filing Document #: 2007000979-8 Pages: 1 <br />Debtor Name: TONY R ROBERTSON <br />Filing Date and Time: 07/23/2020 10:53 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 Tien 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 T0: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />Nebraska ID Number <br />37600982 <br />Federal ID Number <br />Len Serial Number <br />12058343 <br />Lien Filed with: <br />®Asyisser 01 Deeds p county Clerk <br />Social Security Number <br />XXX -XX -6222 <br />Spouse's Social Security Number <br />Dab of Lien <br />July 16,2020 <br />Lien Type: <br />®Original jcorauivation ā¯‘Corrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />TONY R ROBERTSON <br />311 S BERBER ST <br />CAIRO NE 68824-2705 <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 />2013 <br />10/05/2019 <br />$111.82 <br />$42.50 <br />$36.11 <br />190.43 <br />Individual <br />2017 <br />10/05/2019 <br />$364.00 <br />$91.00 <br />$35.85 <br />490.85 <br />Total <br />$681.28 <br />1 certify trot the Nebraska Department 01 Revenue MS conpbed with the laws of IM Slate of Nebraska in determining the amount shown to be due. <br />and that the taxpayer has failed to pay the amen t due after demand. This Notice of State Tan Lien is an effective lien and serves to continue Me priority of <br />the State's interest N the affected goperly of tfjttaxpayer <br />sign <br />here <br />.aI <br />Authorized Signet <br />Revenue Agent 07/16/2020 (308)632-1208 <br />Title Date Pyrone Number <br />Revenue Supervisor 07/16/2020 <br />Tide Dale <br />4.454.1574 nsv. 0.201* Svoentedes a -*-0-1574 Ser. 5-20,3 <br />