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NEB-RAS-KA- Se, EB-R 4A 5e, v 202010057 NE Sec of State - Robert B. Evnen Filing Document #: 2012000923-1 Pages: 1 Debtor Name: ABDIRISAK A HASSAN Filing Date and Time: 12/22/2020 10:05 AM Notice of State Tax Lien This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes administered by the Tax Commissioner, Taxes, including penalties, interest, and costs, which are shown below, are due from the taxpayer and remain unpaid after demand.These taxes are a lien for all property located in the county and rights to property owned by the taxpayer or acquired before the expiration of this Iien.This lien will expire and become unenforceable 10 years after the date of recording if no continuation statement is recorded on or prior to the expiration of the previous Tien or continuation statement. PLEASE 00 NOT WRITE INDUS SPACE Nebraska ID Number 91655862 Federal ID Ntnnner Llan Serial Nun drer 12066810 1 . Find With: ® Reg star a( Deeds [] County Gee Social Security Nu XXX -XX -6565 e's Social Security Number Date of Llan December 18, 2020 Lion Type: ®original []Continuation 0Corrected County HALL e and Location Address Taxpayer Name and Mailing Address ABDIRISAK A HASSAN 712 N WALNUT ST GRAND ISLAND NE 68801 Tax Program Tax Period Date of Assessment Tax Penalty Interest Costs Total Due Individual 2017 03/05/2019 $340.00 $17.00 $40.70 397.70 Total $397.70 sign here I certify that the Nebraska Department of Revenue has complied with the taws of the State of Nebraska in determining the amount shown to be due_ and that the taxpayer has tailed to pay the amount due after demand. This Notice of State Tax Lien is an elIectiNe ken and serves to continue the priority of the State's interest in the affected property 04 the taxpayer. Revenue Agent 12/18/2020 (402)471-5712 Siture Tale Date Phone Number rR«kJ Revenue Supervisor 12/18/2020 trwdzed Spnature Tido Date a 41K-1074 Ren, 11-2049 $40eane.. 4-049.1474 NOV 8.2013