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N Ate-K^t.. NE Sec of State - Robert B. Evncn Filing Document #: 2109000243-7 Pages: 1 Debtor Name: JOSEPH L VAANDERING Filing Date and Time: 09/03/2021 11:19 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 lien. 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 lien or continuation statement. PLEASE DO NOT WRITE IN THIS SPACE Nebraska ID Number 95380027 Federal ID Number Lien Serial Number 12179404 Lien Filed With: ® Register of Deeds 0 County Clerk Social Security Number XXX.X (-1553 Spouse's Social Security Number Date of Lien August 25, 2021 Lien Type: ® Origami ❑ Cominuebon ❑ Cornered County HALL usiness Name and Location Address Taxpayer Name and Mailing Address JOSEPH L VAANDERING 3720 STATE ST APT E10 GRAND ISLAND NE 68803 Tax Program Tax Period Date of Assessment Tax Penalty Interest Costs Total Due Individual 2019 08/07/2020 $475.00 $23.75 S20.25 519.00 Total $519.00 sign here corbry I 0,01 tnot H; Ina S rtnte^.t cl Revenue has cornered with the taws of the State 01 Nebraska in daterminng the amount shown to be due, pay the amount due alter drmand This Notice of State Tar Lien is an effective hen and serves to conlirue the priority of of the taxpayer. Preparers Autn. zed .,gn. tore Revenue Agent Title Revenue Supervisor Title 08/25/2021 (308)632-1210 Date Phone Number 08/25/2021 Date 4.494.1974 Rev, 11-2013 Supen.de 4.949-197u Rev. 8-2013