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NE <br />Good 11.. Great Service. <br />e,wnnan nrt=MN <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2205000339-6 <br />Debtor Name: GREG BUCHTA <br />Filing Date and Time: 05/06/2022 09:21 AM <br />Pages: 1 <br />Notice of State Tax Lien <br />02203376 <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, ore 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 lien.This Oen wit 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 '"rtes SPACE <br />Nebraska ID Number <br />12609455 <br />Fedend ID Number <br />813135771 <br />Liam Serial Number <br />12208700 <br />Lien Flied Wilk <br />Social Security Number <br />XXX -XX -9503 <br />Spouse% Social Security Number <br />NO SPOUSE SSN <br />Ek Register a assts ©tooarlyClerk <br />Date of Lien <br />May 2, 2022 <br />Lien Type: <br />0etglrml [1 continuation ❑ Connoted <br />County <br />HALL <br />Business Name and Location Address <br />axpayer Name and Mating Address <br />GREG BUCHTA <br />D/B/A 8 & B TREE LLC <br />4174 ARIZONA AVE <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 />Sales <br />01/01/2020 - 09/30/2021 <br />02/26/2022 <br />4,935.00 <br />987.00 <br />208.78 <br />.00 <br />6,130.78 <br />Withholding <br />01/01/2020-09/30/2021 <br />02/26/2022 <br />19,985.00 <br />6,566.50 <br />822.95 <br />.00 <br />27,374.45 <br />Total <br />33,505.23 <br />I certify that the Nebraska Departmental Revenue hes complied with the laws of the State of Nebraska in determining the amours shown to be due, <br />and that Nur taxpayer has failed to pay the amount due alter demand. This Notice of State Tax tien Isan effective lien and serves to continue the priority of <br />the State's Merest In the affected properly of the taxpayer. <br />sign. Lf/fr Revenue Agent 05/02/2022 402-471-5717 <br />1:.Tide <br />Revenue Manager Date <br />Phone Number <br />here <br />lzed Striatum rive Date <br />4484-1974 Rev, 84003 94pe9e649 49494974 Rex 8-2013 <br />