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Good life. Great Sentice. <br />NE Sec of Slate - Robert B. Evnen <br />Filing Document #: 2302000304-2 <br />Debtor Name: BRAD SCELLIN <br />Filing Date and Time: 02/08/2023 10:07 AM <br />Pages: 1 <br />Notice of State Tax Lien <br />202300629 <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, end 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 W THIS SPACE <br />Nebraska ID Number <br />13549480 <br />Lien Serial Number <br />12314661 <br />Date of Lien <br />February 2, 2023 <br />Federal ID Number <br />204787022 <br />Lien Filed With: <br />El Register or Deeds © County Clerk. <br />Social Security Numbs <br />NO SSN <br />Type <br />Lien <br />Original <br />Ei <br />Continuation ❑Car <br />Business Name and Location Address <br />r Spouse's Socsal Security Number <br />NO SPOUSE SSN <br />County <br />e HALL <br />Taxpayer Name and Malting Address <br />BRAD SCELLIN <br />S -FIVE PROMOTIONS INC <br />131 E MAIN ST APT 41 <br />SEWARD NE 68434 <br />Tax Program <br />Tax. Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Waste Reduction <br />07101;2018 - 06/30;2019 <br />09/23/201 <br />25.00 <br />.00 <br />3.14 <br />.00 <br />28.14 <br />Waste Reduction <br />07/01/2019 -.0613012020 <br />12/14/2020 <br />25.00 <br />5.00 <br />1.77 <br />.00 <br />31.77 <br />Withholding <br />01/01/2020 - 03/31/2020 <br />06/24/2020 <br />.00 <br />13.15 <br />.97 <br />.00 <br />14.12 <br />Withholding <br />04/01/2020 - 06/30/2020 <br />01/11/2021 <br />275.00 <br />82.50 <br />23.51 <br />.00 <br />381.01 <br />Withholding <br />07/01/2020-09/30/2020 <br />01/11/2021 <br />275.00 <br />41.25 <br />20.05 <br />.00 <br />336.30 <br />Total <br />791.34 <br />I certify that the Nebraska Deparbnent of 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 after demand. This Notice of State Tax Lien Is en effective lien and serves to continue the priority of <br />the States interest in the attewted property of the taxpayer, <br />sign te, Revenue Tax Specialist Senior 01/26/2023 402-471-6067 <br />here Preparat's Signaturap TNe Date Phone Number <br />Revenue Supervisor 2/3/2023 <br />Authar=zdd 8lgnature Tide <br />Date <br />4-499-te74 Rev. 8.2018 Superseder 4449.1979 Rev.$ -501 <br />