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NEBRASKA - <br />60/ <br />EB ASKA <br />Gaod I. to. Groat nce. <br />04..1171411.011. INVItillar <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2207001268-4 Pages: 1 <br />Debtor Name: COLE KOWALSKI <br />Filing Date and Time: 07/22/2022 10:14 AM <br />Notice of State Tax Lien <br />20220541q <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 />96148942 <br />Fedea'al ID Number <br />NO FEIN <br />Lien Serial Number <br />12203674 <br />Lien Filed With: <br />IX) Register of Deeds 13 County Clerk <br />Social Security Number <br />XXX -XX -3316 <br />Spouses Social Security Number <br />NO SPOUSE SSN <br />Date of Lien <br />July 19, 2022 <br />Lien Type: <br />❑corrected <br />County <br />HALL <br />E4 Original 1 Continuation <br />Business Name and Location Address <br />axpayer Name and Mailing Address <br />COLE KOWALSKI <br />266 A ROAD <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 />2015 <br />05/15/2021 <br />$15,976.00 <br />$3,994.00 <br />$3,641.65 <br />$23,611.65 <br />Individual <br />2017 <br />05/15/2021 <br />320,197.00 <br />$5,049.25 <br />$3,391.99 <br />$28.638.24 <br />Individual <br />2018 <br />05/15/2021 <br />$13,349.00 <br />$1,334.90 <br />$1,568.97 <br />$16,252.87 <br />Individual <br />2019 <br />05/15/2021 <br />$1,672.00 <br />$418.00 <br />$116.35 <br />$2,206.35 <br />Total <br />$70,709.11 <br />sign <br />1 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 atter demand. This Nonce of State Tax Lien is an effective lien and serves to continue the priority of <br />the Slate's interest in the affected properly ut the taxpayer. <br />here • Dreamer's Signature <br />d Signalur1r <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />07/19/2022 (402)471-6043 <br />Dale Phone Number <br />07/19/2022 <br />Title Date <br />«84-1974 Rev. 8-2018 Supersedes 4-949-1974 Fyv.1-2013 <br />