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Good 044.. Grlav Service <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2011000003-7 Pages: 1 <br />Debtor Name: MARTINA TASEVSKA <br />Filing Date and Time: 11/02/2020 09:41 AM <br />Notice of State Tax Lien <br />20200856i <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 00 NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />11870060 <br />Federal D Number <br />No Federal ID <br />Lien Serial Number <br />12064556 <br />Lien Filed With, <br />Social Security Number <br />XXX -XX -0293 <br />Spouses Social Security Number <br />® Register at Deeds • County Clerk <br />Dale of Lien <br />October 27, 2020 <br />Lien Type: <br />® Original 0Continuation 0Corrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />MARTINA TASEVSKA <br />T-SHIRT FACTORY <br />8233 HARDING AVE APT 607 <br />MIAMI BEACH FL 33141 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />fax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Sales <br />10/01/2018 - 09/30/2019 <br />06/28/2020 <br />260.00 <br />52.00 <br />13.28 <br />.00 <br />325.28 <br />Total <br />325.28 <br />sign <br />here <br />I certify that the Nebraska Department of Revenue has complied with the laws of the Stals of Nebraska in determining the amount shown robe due. <br />and that the taxpayer has failed to pay the amount due alter demand. This Notice of Stale Tax Lien a an effective lien and serves to continue the priority of <br />the Style's al�arfst in the affected properly of the taxpayer. <br />Prepares Signet% /t A <br />C �j <br />Aulhorizod Signature <br />Revenue Agent 10/27/2020 402-471-5704 <br />Title Date Phone Number <br />Revenue Senior Agent 10/27/2020 <br />Tido ate <br />4-494-1974 has. 620'8 SuOewthes 4.949-,974 Ram 62013 <br />