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NtERI;ZASKA <br />0.1.,111.1 PkVCIAM <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2208000253-4 <br />Debtor Name: MATTHEW P KERR <br />Filing Date and Time: 08/05/2022 10:57 AM <br />Pages: 1 <br />Notice of State Tax Lien <br />202205818 <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 ail 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 if) NionborI'OOe: <br />99170914 <br />al ll) Number <br />NO FEIN <br />t.iaa Serial Number <br />12204718 <br />Lien Filed With <br />[J Register of Deeds ❑ Cooly Clerk <br />Social Security Number <br />XXX -XX -8701 <br />Spouse's Soc a1 Security Number <br />XXX -XX -4135 <br />Dale of Lien... <br />August 1, 2022 <br />Iter- Type: <br />DCorrected <br />County <br />HALL <br />I;4 (7tiginal [3Contnuatir,n <br />ustne <br />$ N <br />e and Location Address <br />Taxpayer Name and Mailing Address <br />MATTHEW P KERR <br />CINDY K KERR <br />3225 N MONITOR RD <br />GRAND ISLAND NE 68803 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penally <br />Interest <br />Costs <br />Total Due <br />Individual <br />2015 <br />10/2712019 <br />$.00 <br />$.00 <br />$111.33 <br />$111.33 <br />Individual <br />2016 <br />10/27/2019 <br />$339.00 <br />816.95 <br />$40.77 <br />8396.72 <br />Individual <br />2017 <br />10/27/2019 <br />$110.00 <br />$27.50 <br />$18.59 <br />$156.09 <br />Individual <br />2019 <br />08/07/2020 <br />$194.00 <br />$9.70 <br />$13.71 <br />$217.41 <br />Total <br />$881.55 <br />1 cerbry that the Nebraska Department of Revenue has smrnplied with Me tans of nrn Sla10 of Nebraska in determining the amount shown kr bu due, <br />and that the taxpayer has tested 10 pay the aroonl due &Iv demand, Shis NOtiee of State Tax Iden is an effective 1100 and servos to continue fur serienty of <br />leo Staten. iniorest in the affected properly 01 the taxpayer. <br />sign "t,�-Ar <br />here reparers. Signature <br />.r/06p. <br />Authorized 5,(,5101010 <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />08/01/2022 (300)632-1210 <br />Date Phone Number <br />08/01/2022 <br />tie Desk <br />0.434. 901 r,ev. 6-2('18 SwNae00n 4040.1074 ale, 0.21`3 <br />