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NE4A. <br />NE Sec of State- Robert B. Evnen <br />Filing Document #: 2208000691-0 Pages: 1 <br />Debtor Name: ALLEN H PRICE <br />Filing Date and Time: 08/18/2022 09:28 AM <br />Notice of State Tax Lien <br />202206088 <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 00 NOT WRITE IN THIS SPACE <br />Nebraska ID Nomtx*r <br />36346586 <br />Lien Serial Nurrrber <br />12205621 <br />Date Of L:Ie?n <br />August 10, 2022 <br />Federal ID Number <br />NO FEIN <br />Sen Filed With: <br />Replete, of Deeds 0 Courtly Clerk <br />Lien Type: <br />® Original E Continual Cfl <br />Social Security Number <br />XXX -XX -2291 <br />[] Corrected <br />Spouses Social Security Number <br />NO SPOUSE SSN <br />COuoty <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />ALLEN H PRICE <br />709 W STOLLEY PARK RD <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period <br />Date of <br />Tax <br />Penalty <br />Interest Costs <br />Total Due <br />Assessment <br />1 <br />3 <br />Individual <br />2019 <br />08/07/2020 <br />$20.00 <br />$1 00 <br />$1.431 <br />$22.43 <br />Individual <br />2020 <br />06/11/2021 <br />$335.00 <br />$16.75 <br />$12.39; <br />r <br />$364.14 <br />Individual <br />2021 <br />05/04/2022 <br />$324.00 <br />$16.20 <br />$3.12.. <br />$343.32 <br />Total <br />$729.89 <br />1 certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska to dater*.fining the amount shown to be due. <br />and %Fal fie taxpayer has failed to pay the amount due after demand. TIPS Notice al Slate 'tar Deft IS an etteetrva lies and SertreS f0 Continue a priority Ol <br />the Slate's artereet in the affected property 01 rte taxpayer. <br />sign <br />herr 6h puee's S:ynafore <br />aeLLa 4.4442.. <br />Air la untrue Siynalore <br />Revenue Agent <br />Title <br />08/10/2022 (308)632-1206 <br />Date Phone Number <br />Revenue Supervisor 08/10/2022 <br />ale Date <br />44.94-r ?e }lnr. wile a Sunerssoes 440• 1974 toes. 8.?0l3 <br />