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N, <br />Gaal Li`e, Great Service. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2303000979-9 Pages: 1 <br />Debtor Name: DUSTIN REISS <br />Filing Dale and Time: 03/22/2023 11:52 AM <br />Notice of State Tax Lien <br />202301353 <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 />Nebraska ID Number <br />99903369 <br />Federal ID Number <br />NO FEIN <br />Lien Serial Number <br />12324267 <br />lien Filed With: <br />® Register of Deeds ©County Clerk <br />Social Security Number <br />XXX -XX -7358 <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />Date of Lien <br />March 17, 2023 <br />Lien Type: <br />0Corrected <br />County <br />HALL <br />E:i Original 0Contkmation <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />DUSTIN REISS <br />2805 SOUTH CUNBARREL ROAD <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2019 <br />11/12/2021 <br />$241.00 <br />$350.50 <br />$83.25 <br />$674.75 <br />Total <br />$674.75 <br />sign <br />here <br />I certify Fret the Nebraska Department 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 altar demand. This Notice of State Tax Lien is an eftecOva lien and serves to continue the priority of <br />the State's kderent In the elected property of the taxpayer. <br />Preparers Signature <br />Revenue Agent 03/17/2023 (402)171-0987 <br />Title Date Phone Number <br />Revenue Supervisor 03/17/2023 <br />Title <br />Date <br />4,454.1074 Ree 5-2010 Supersedes 4.949.1574 Ren, 82913 <br />