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202106413
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7/28/2021 3:55:53 PM
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7/28/2021 3:55:53 PM
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DEEDS
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202106413
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o(1' <br />N_EBR <br />&c...I Lite. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2107001740-4 Pages: 1 <br />Debtor Name. MICHAEL W GOODER <br />Filing Date and Time: 07/28/2021 12:01 PM <br />Notice of State Tax Lien <br />20210641.3 <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 Tien for all property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of thls Iien.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 />Nebraska ID Number <br />31778860 <br />Federal ID Number <br />Lien Serial Number <br />12177154 <br />Lien Filed With. <br />® Register of Deeds [ County Clerk <br />Social Security Number <br />XXX -XX -2435 <br />Spouse's Social Security Number <br />Date of Lien i Lien Type <br />July 23,2021 I [X]Original [Continuation [Corrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />MICHAEL W GOODER <br />1816 W 9TH <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 />2018 <br />02/1012021 <br />$374.00 <br />S37.40 <br />$32.86 <br />444.26 <br />Total <br />$444.26 <br />l certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska to doterminmg the amount shown to be clue. <br />and that the taxpayer has failed to pay the amount due after demand. This Notice of State Tax Lien is an effec0ee Den and serves to continue the priority of <br />the Status interest in the affected property 01 the taxpayer. <br />sign <br />here r Preparers Sigma <br />Revenue Agent 07/23/2021 (402)471-5833 <br />Ticks Date Phone Number <br />Revenue Supervisor 07123/2021 <br />Title Date <br />4494.1974 Rev 6.2018 Swrsedee 4.949.1974 Rev. 84013 <br />
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