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NE Sec of State - Robert B. Evnen <br />Filing Document #: 2010000817-3 Pages: 1 <br />Debtor Name: KYLE S USREY <br />Filing Date and Time: 10/20/2020 09:52 AM <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />Notice of State Tax Lien <br />202008044 <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 />Nebrasroa ID Nâś“rubor <br />44704402 <br />Tax Period <br />I. Date of <br />IAssessment <br />Federal ID Number <br />lien Serial NUMbe, <br />12063350 <br />Costs j Total Due <br />Len Fled With: <br />y, Regular of Deeds <br />fJ Ceoniy Cw,k <br />Social Security Number <br />XXX -XX -9494 <br />Spouas s SobaI Seccrily hvmDi, <br />Dale of Lien <br />October 09, <br />2020 <br />Len Type: <br />NOriginal <br />0Cdntinuaten I: Corrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />KYLE S USREY <br />706 W HEDDE ST APT 13 <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period <br />I. Date of <br />IAssessment <br />Tax 1 <br />Penalty 1 Interest <br />Costs j Total Due <br />Individual <br />2016 <br />. 01/18/2020 <br />$392.001 <br />$19.60, $54.93 <br />466.53 <br />Total <br />$466.53 <br />I certify Slat the Nebraska Department tt Revenue has complied with the laws of the State of Nebraska in determining the amount shown to be due, <br />and teat the taxpayer has tailed to pay the amount doe alter demand. This Notice of State Tao Les is an effective Sm and serves to continuo the prioiay of <br />the States merest 1n the altectod p.operty Ct the taxpayer, <br />Revenue Agent <br />Tate <br />10/09/2020 (402)471-5713 <br />Cate Phone Number <br />10/09/2020 <br />Title <br />Date <br />X194'974 Rev. &2515 Sapenetos 6949.+976 nos, . 21-2013 <br />