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NE <br />Cib,::u1 Life. Sleet Service. <br />.11.4114.1 0, OIVOne <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2304000707-3 <br />Debtor Name BOBBY LEETCH <br />Filing Dale and Time: 04/17/2023 10:05 AM <br />Pages: I <br />Notice of State Tax Lien <br />202301857 <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 />98493248 <br />Fedora) ID Number <br />NO FEIN <br />Lien Serial Number <br />12326704 <br />Lien Filed IMIE: <br />Social Security Number <br />XXX -XX -8011 <br />Spouse's Social Security Number <br />XXX -XX -8004 <br />rA Register of Deeds ® county Clerk <br />Data of Lien <br />April 6, 2023 <br />Lien Type: <br />®Original 0continuation ❑corrected <br />County <br />HALL <br />uslness Name and Location Address <br />Taxpayer Name a <br />Mailing Address <br />BOBBY LEETCH <br />JENIFER LEETCH <br />550 3RD RD <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 />2016 <br />08/30/2022 <br />$1202.00 <br />$300.50 <br />$270.04 <br />$1,772.54 <br />Total <br />$1.772.54 <br />1 certify that the Nebraska Dopar tment of Revenue has complied with the laws of the Stale of Nebraskain determining the amours shown to be due, <br />and that the taxpayer has tailed to pay the amount due after demand. This Notice of State Tax Lien is an effective lien and serves to continua the pooray of <br />the Slate's interest In bre affected properly of the taxpayer. <br />sign 4% 40,2,g <br />here r eparer's ��/alp e <br />Authorized Signature <br />Revenue Agent 04/08/2023 (308)632-1201 <br />Title Date Phone Number <br />Revenue Supervisor 04/06/2023 <br />Title Dale <br />4.494-1974 R4f. 8$015 Supers/Nu 4.949-t074 Rev 5.2013 <br />