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NEBRA-644A- <br />Gouillau.SriNKScrvim, <br />NE Sec of State - Robert B. Emen <br />Filing Document #: 2109001209-0 Pages: 1 <br />Debtor Name: LANETTE NIEDFELT <br />Filing Date and Time 09/24/2021 09:37 AM <br />Notice of State Tax Lien <br />202108155 <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 awned 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 DO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />40462048 <br />Federal 0 Number <br />Lien Serial Number <br />12181130 <br />Lien Filed With <br />® Register of Deeds D County Clerk <br />Social Security Number <br />XXX -XX -7900 <br />Spouse's Social Security Number <br />Dale of Lien <br />September 21, 2021 <br />Lien Type:. <br />®original ❑Contirawtidn 0 Corrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mallin <br />Address <br />LANETTE NIEDFELT <br />1620 WEST JOHN ST <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />1 Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2017 <br />11/04/2020 <br />$646.04 <br />$556.00 <br />$297.54 <br />1,499.58 <br />Total <br />$1,499.58 <br />sign <br />I certify Mal the Nebraska Department of Revenue has Complied with the laws of the Stale of Nebraska in determining the amount shown to be due, <br />and that the taxpayer has failed to pay the amount due after demand. This Notice of State Tax Uen is an effective hen and serves to continue the priority of <br />the State's interest in the effected property of the taxpayer. <br />here ,rnSgntwe <br />Authorized Signature <br />..--f <br />Revenue Agent 09/21/2021 (402)471-0987 <br />Title <br />Revenue Supervisor <br />Date <br />Phone Number <br />09/21/2021 <br />Title Date <br />s.494 -t974 Rev. 8.2019 Supersedes 4.9491974 Rev, 8-2013 <br />