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Good L+fr. Great Sery ce <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2110000046-2 Pages: 1 <br />Debtor Name: VICTOR M DERAS <br />Filing Date and Time: 10/04/2021 10:00 AM <br />Notice of State Tax Lien <br />202108430 <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 ell property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this 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 />35582189 <br />Federal IO Number <br />Lien Serial Number <br />12181764 <br />Lien Filed With: <br />Social Security Number <br />XXX -XX -9444 <br />Spouse's Social Security Number <br />i7 Register of Deeds ❑ County Clerk <br />Date of Lien <br />September 29, 2021 <br />Len Type: <br />❑correned <br />County <br />HALL <br />® original ■ Continuation <br />usiness Name and Location Address <br />Taxpayer Name and Mailing Address <br />VICTOR M DERAS <br />2520 COLLEGE STREET <br />GRAND ISLAND NE 68803 <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 />2013 <br />09/20/2019 <br />$874.22 <br />$229.25 <br />$241.53 <br />1,345.00 <br />Individual <br />2014 <br />09/20/2019 <br />$1,315.00 <br />$328.75 <br />$307.64 <br />1,951.39 <br />Individual <br />2015 <br />09/20/2019 <br />$897.00 <br />$224.25 <br />$182.87 <br />1,304.12 <br />Individual <br />2016 <br />09/20/2019 <br />$1,140.00 <br />$285.00 <br />$198.20 <br />1,623.20 <br />Individual <br />2017 <br />09/20/2019 <br />$514.00 <br />$141.00 <br />$80.11 <br />735.11 <br />Total <br />$6,958.82 <br />I certify that the Nebraska Department of Revenue has complied won the laws of the State of Nebraska in determining the amount shown to be due, <br />and that the taxpayer has failed to pay the amount due alter demand. The Notice of State Tax Lien a an effective lien and serves to continue the priority of <br />the Stab's interest in the elected property of the taxpayer. <br />sign/ Revenue Agent 09/29/2021 (402)471-0987 <br />here, Preparer's Signature / / Title Date Phone Number <br />•...fes -: (r ReSupervisor 09/29/2021 <br />Aflthorised Signa%ixe Title <br />Date <br />4-x94.1974 Pox 62015 Supersedes 49441920 Rev. 62013 <br />