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NtEB &KA-. <br />411, <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2208000648-8 Pages: 1 <br />Debtor Name: DOUGLAS EHLERS <br />Filing Date and Time: 08/17/2022 08:36 AM <br />Notice of State Tax Lien <br />202206061 <br />This Notice of State Tax Lien is is .red 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 />29772524 <br />Federal D Number <br />NO FEIN <br />teen Se -tat Number 1 Lien Filed With: <br />12205342 1 ® flegmier of Deeds ❑ County Clerk <br />Social Security Number <br />XXX -XX -7070 <br />Spouses Social Sec, rity Number <br />NO SPOUSE SSN <br />Date of Lien j Lice type; <br />August 8, 2022 j 0,, ,w ❑ Cvntinualenr 0 Corrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />DOUGLAS EHLERS <br />518 E ASHTON AVE <br />GRAND ISLAND NE 68801 <br />[ Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest 1 <br />Costs <br />Total Due <br />Individual <br />2020 <br />06/11/2021 <br />$2,953.18 <br />$363.11 <br />$152.30 <br />$3,468.59 <br />Total <br />$3,468.59 <br />sign <br />here <br />I cert:ty that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska In defer^knie9 the amount shown to be due, <br />and thal the taxpayer has tailed to pay the amount due atter demand. This Notice of State Tax Lien is an efleciive lien and serves to continue the priority of <br />the State's interest in the affected property of the taxpayer. <br />f'l,ipanx's Signahmr <br />rdiiit SIgnatU/:: y. <br />Revenue Agent <br />Tale <br />08/08/2022 (402)471-5712 <br />Date Phone Number <br />Revenue Superyisor 08/08/2022 <br />t ale hate <br />4-144-19MA nek. 32016 Suetre4005 4.920.19..: ev. 8-2613 <br />