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Gond Life. Great `_trv,Ce. <br />04.4011M41. INVGA010. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2110001024-7 Pages: 1 <br />Debtor Name: APRIL HARDY <br />Filing Date and Time: 1026/2021 11:35 AM <br />Notice of State Tax Lien <br />20 2109068 <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 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 />11801654 <br />Lien Seeiat Number <br />12104693 <br />Date of Lien <br />October 15, 2021 <br />Federal 10 Number <br />464209680 <br />Lien Filed With: <br />© Register of Deeds 0 County Clerk <br />Social Security Number <br />XXX -XX -3837 <br />Spouses Social Security Number <br />Gen Type: <br />® Original Continuation O Cor <br />County <br />Corrected <br />Business Name and Location Address <br />HALL <br />Taxpayer Name and Mailing Address <br />APRIL IIARDY <br />QUALITY CLEANING PLUS <br />318N WHITE AVE <br />GRAND ISLAND NT 68803 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Saks <br />01/01,2018 - 09/30/2018 <br />02/01/2019 <br />.00 <br />200.00 <br />40.00 <br />.00 <br />240.00 <br />Sales <br />]0101/2018- 10/31/2018 <br />03/03/2019 <br />.00 <br />37.50 <br />7.74 <br />.00 <br />45.24 <br />Saks <br />11/01/2018 - 11/30/2018 <br />02/01/2019 <br />.00 <br />25.00 <br />6.31 <br />.00 <br />31.31 <br />Sales <br />12)01/2018- 12/31/2018 <br />05/01/2019 <br />.00 <br />25.00 <br />7.12 <br />.00 <br />32.12 <br />Sales <br />01/01/2019 - 03/31/2019 <br />08/04/2019 <br />.00 <br />118.50 <br />21.75 <br />.00 <br />140.25 <br />Sales <br />04101/2019- 12/31/2019 <br />04/01/2020 <br />.00 <br />200.00 <br />21.61 <br />.00 <br />221.61 <br />Sales <br />01/01/2020 - 12/31/2020 <br />04/23/2021 <br />976.77 <br />516.00 <br />78.28 <br />.00 <br />1,571.05 <br />Sales <br />01/01/2021 - 03/31/2021 <br />0610112021 <br />206.01 <br />50.00 <br />3.43 <br />.00 <br />259.44 <br />Total <br />2,541.02 <br />I certify that the Nebraska Department of Revenue has complied with the taws of the Stele of Nebraska in determining the amount shown to be due, <br />and that the taxpayer hes laded to pay the amount due atter demand. This Notice of State Tax Lien is an effective lien and serves to continue the priority of <br />0,u Slate's interest in the affected properly of the taxpayer. <br />sign <br />here Prep rens 7, ;' ex <br />stato <br />-Authorized Signature <br />Revenue Agent 10/13/2021 402-471-5717 <br />Title Date Phone Number <br />Revenue Senior Agent /D • /s` 2a 21 <br />Date <br />4.494.1974 ItOn. 8-2018 Supersedes 4.949.1974 Rest 9-2013 <br />Title <br />