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CIA <br />NEBRASKA - <br />Good Life. Great Service. <br />awwr.,,,„ <br />2208043 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2211000571-1 Pages: 1 <br />Debtor Name: SISSY .1 SALE <br />Filing Date and Time: 11/16/2022 11:17 AM <br />Notice of State Tax Lien <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 IIen.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 />Nebraska ID Number <br />94048908 <br />PLEASE DO NOT WRITE MINIS SPACE <br />Lien Serial Number <br />12214403 <br />Date of Lien <br />November 14, 2022 <br />Lien Filed With: <br />CE Register of Deeds 0 County <br />Len Type: <br />Federal ID Number <br />NO FEIN <br />Original 0 Continua <br />Business Name and Location Address <br />Social Security Number Spouse's Sots Security Number <br />XXX -XX -2108 NO SPOUSE SSN <br />County <br />0Corrected <br />HALL <br />Tax Program Tax Period <br />Individual 2016 <br />Individual 2017 <br />Taxpayer Name and Mailing Address <br />SISSY J SALE <br />223 E 20TH ST APT 3094 <br />GRAND ISLAND NE 68801 <br />Date of Tax Penalty Interest <br />Assessment <br />10/18/2021 52,570.61 5128.80 5534.83 <br />06/30/2021 51,551.98 590.20 $311.57 <br />Costs <br />Total Due <br />Total <br />$3,234.24 <br />51,953.75 <br />$5,187.99 <br />�. I certify thatNebraska tailed <br />Department of Revenue hes complied �n one laws of the State of Nebraska in delerminl g the amount shown to be due, <br />and Mat the to pay Me amount due after demand. This Notes of State Tax Lien is an effective lien and serves 10 continue the <br />the State's interest in Me afecled property of the taxpayer. 6Y of <br />sign <br />here <br />arer's Signature `J <br />ed Signature <br />Revenue Agent 11/14/2022 (402)471-5928 <br />Title Date Phots Number <br />Revenue Supervisor 11/14/2022 <br />Title <br />Date <br />4.494.1974 Rex 6.2018 Supeaad:a 4409.1974 Rex &2013 <br />