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Good L:tr, Great Ser•,:ce <br />wwaarwsMr M MVanW <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2110001025-6 Pages: 1 <br />Debtor Name: WILLIAM E LAWREY JR <br />Filing Date and Time: 10/262021 11:36 AM <br />Notice of State Tax Lien <br />Q,0 210 9 0 6 9 <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 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 00 NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />38463369 <br />Federal D Number <br />Lien Serial Number <br />12183053 <br />Lien Filed With: <br />® Mister of Deeds [j County Cterk <br />Social Security Number <br />XXX -XX -2394 <br />Spouse's Social Security Number <br />Date of Lien <br />October 19, 2021 <br />1 _ • <br />Lien Type: <br />COU,gy <br />HALL <br />L1 Original a Contin..t n <br />■ Corrected <br />mess Name and Location Address <br />Taxpayer Name end Mailing Address <br />WILLIAM E LAWREY JR <br />2528 W JOHN ST <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 />2015 <br />03/26/2021 <br />55,377.00 <br />$1,344.25 <br />$1,105.01 <br />7,826.26 <br />Total <br />57,826.26 <br />I certify that the Nebraska Department of Revenue has complied with the taws of the State of Nebraska In determining the amount shown 10 be due, <br />and that the taxpayer has failed to pay the amount due after demand, This Notice of State Tax Lion la an effective Oen and serves to continue the priority of <br />the State's interest in the affected properly of the taxpayer, <br />sign <br />here ',Pr- rer's Si of <br />,zed Signature <br />Revenue Agent <br />TNIe <br />Revenue Supervisor <br />10/19/2021 (402)471-0987 <br />Date Phone Number <br />10/19/2021 <br />Title Date <br />4404.1974 nev.0.2010 Supenedea 4-040.1074 Rex 84013 <br />