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NFJ3t ', &34A- <br />tg...6t*PIM IO H YKY4r. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2208000647-9 Pages: 1 <br />Debtor Name: YUNIET QUIGNON <br />Filing Date and Time 08/17/2022 08:35 AM <br />Notice of State Tax Lien <br />202206060 <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 />Nebraxet ID Number <br />47412585 <br />Federal ID Number <br />NO FEIN <br />Len Serial Number <br />12205338 <br />Lion Fred With: <br />Register of Deeds 0County Clerk <br />Social Security Number <br />XXX -XX -4371 <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />Date of Liem <br />August 8, 2022 <br />Lion Type: <br />x Original [3 Continuation 0Corrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />YUNIET QUIGNON <br />2528 STAGECOACH ROAD <br />GRAND ISLAND NE 68801 <br />Tax Program j Tax Period <br />f <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual 2019 <br />08/07/2020 <br />$1,022,00 <br />$106.10 <br />$78.88 <br />$1,206.98 <br />Total <br />$1,206.98 <br />I certify that the Nebraska Department or .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 ben and serves to continue the priority of <br />the State's interest in the affected property of the taxpayer, <br />sign /<a-440.1.4.- Revenue Agent 08/08/2022 (402)471-5833 <br />here r Preparers Signature Tifle Dale Phone Number <br />4,446, Revenue Supervisor 08/08/2022 <br />Authorized Signature 'Tide Date <br />4-4f4't914 ticv. n.5118 9 twedas 4=049.10ta Per. ltdl'13 <br />