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N-IEBGd A - <br />Good ;.+te. Cr ear Se•s'iar. <br />aiM•1iortM IRN .4 <br />NE Sec of Slate - Robert B. Evneo <br />Filing Document #: 2207000887-6 Pages: 1 <br />Debtor Name: NANCY K SAVAGE <br />Filing Date and Time: 07/14/2022 10:01 AM <br />Notice of State Tax Lien <br />202205194 <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 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 />26144662 <br />Federal 0 Number <br />NO FEIN <br />Lien Serial Number <br />12202729 <br />Lien Filed With: <br />Register of Deeds ❑ County Clerk <br />Social Security Number <br />XXX -XX -6678 _...... <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />Data of Lien <br />July 6, 2022 <br />Lien Type, <br />® Origins)! ❑Continuatbn <br />10/28/2020 <br />County <br />HALL <br />■ Corrected <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />NANCY K SAVAGE <br />604 W HEDDE <br />GRAND ISLAND NE 68801 <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 />2019 <br />10/28/2020 <br />$3,223.00 <br />$257.15 <br />$220.84 <br />$3,700.99 <br />Individual <br />2020 <br />11/05/2021 <br />$844.00 <br />$58.29 <br />$28.79 <br />$931.08 <br />Total <br />$4,632.07 <br />I certify that the Nebraska Department of Revenue has complied with 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. This Notice of State Tax Lien Is an effective lien and serves to continue the priorly of <br />the Slates interest in the selected property of the taxpayer. <br />sign / <br />here)" Prepare14nax l �3oP as h <br />//r's ASig--Atture4461a, <br />7 <br />Authorized Signature <br />Revenue Agent 07/06/2022 (402)471-5833 <br />Title Dale Phone Number <br />Revenue Supervisor 07/06/2022 <br />Title Date <br />4-494-1974 Rent. &tete Supersedes 4449.1974 Fleet 84013 <br />