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NEBRASKA - <br />04,11.111T...11 F f� A S K <br />NE Sec of State - Robert B. Evnen :?0210030 <br />Filing Document #: 2101000428-4 Pages: 1 <br />Debtor Name: YSHAK YESIN <br />Filing Date and Time: 01/12/2021 09:14 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 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 />• <br />ft <br />PLEASE DC NOT WRITE IN THIS SPACE <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />Neeras¢a ID Numtwr <br />47175095 <br />Len Saral NUmtmr <br />12167300 <br />(tato of Lien <br />January 08, 2021 <br />lien Filed kWh. <br />Register at Deeds <br />Lien Type: <br />® Original <br />Federal D Number <br />Sial Security Number: <br />County Clerk I XXX -XX -1369 <br />Spouse's Saul Secut ty Number <br />0 Continuation Correctea <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />YSHAK YESIN <br />412 E YUND ST <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period Date of <br />Assessment <br />i <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2016 <br />11/23/2019 <br />$576 521 <br />$51.05 <br />$140.75 <br />768.32 <br />Individual <br />2017 <br />11/23/2019 <br />I <br />1 <br />$686.001 <br />$34.30 <br />$83.81 <br />804.11 <br />Total <br />$1,572.43 <br />I realty that the Neorasxa Department of Revenue Nils compked With ate laws of the State ti NOtxeeks in determining the amount shown to be due, <br />and that t:`,t, taxpayer ran tailed In pay the amount due atter demand. The Notice of State Tax :AM a an effective ken and tomes to Continue the prearity of <br />are State's interest in the alluded property of the taxpayer. <br />sign <br />here, Prepare', L <br />Wm <br />u; edSignatare 7 rtte <br />Revenue Agent 01/08/2021 (308)632-1208 <br />?ate Date Phone Number <br />Revenue Supervisor 01/08/2021 <br />Dal: <br />4.ee4-t3T4 c« -c It-Od'a ttutrara0eas 4-2a9-1074 tNv. a-2Qi+T <br />