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Gaon L:ie Orear. Sery--e. <br />onnsrwrur or,rcvaws <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2010000818-2 Pages: 1 <br />Debtor Name: KYLE S USREY <br />Filing Date and Time: 10/20/2020 09:53 AM <br />Notice of State Tax Lien <br />202008045 <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 />Nobrasw ID Number <br />44704402 <br />Federal 0 Number <br />Len Serial Number <br />12063350 <br />lien I gen With: <br />lid Heeister of Deeds (- C Gerin <br />Social Security Number <br />XXX -XX -9494 <br />Spouses Socel Security Number <br />Date of Leo <br />October 09, 2020 j <br />Lien Pipe <br />®UrgkLal LiContir,uatwn El Corrected <br />County <br />HALL <br />usiness 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 />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2016 <br />01/18/2020 <br />$392 00 <br />$19.60 <br />$54.93 <br />466.53 <br />Total <br />$466.53 <br />sign <br />here <br />I certify I <br />and that t <br />the State <br />:r <br />NEL <br />r <br />or Revenue has complied with the laws of the State of Nebraska or determining the amount shown to be due. <br />amount due after demand. This Notice of State Tax Lien is an effective lien and serves In continue the priority of <br />r the taxpayer. <br />Revenue Agent 10/09/2020 (402)471-5713 <br />Tice Dale Phone Number <br />AILLevnal 4 10/09,2020 <br />Auttm>Izdd Su lure Title Date <br />4.494.1974 Rev. 8-2C1e Supxseduo 4949.1974 Pay 5-2013 <br />