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202302381 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2305000554-2 Pages: 1 <br />Debtor Name: BRANDON JAMES GROSSART <br />Filing Date and Time: 05/16/2023 12:06 PM <br />NEBRASKA <br />Notice of State Tax Lien <br />L en Serial Namur <br />1L3/.3:c% <br />Lien Type <br />Dti 'mat <br />ReSe.sa <br />Date <br />04/12/2023 <br />send Sevens, riutstar <br />Xa'{ <br />interest <br />Nebrasx2 i. D. *.0 <br />4844 <br />Cooney <br />Han <br />_ten Pitted mean <br />Rarest o'Deeds <br />fEtte Number <br />47-5619520 <br />BUSINESS NAME AND LOCATION ADDRESS <br />3:.stneSs Name <br />Brandon James Grossatt <br />TAXPAYER NAME AND MAILING ADDRESS <br />Name <br />Brandon James Grossed <br />Sheet Addrets <br />2004 E 71h St <br />Street or 0t-er ma Ag Aydresa <br />2004 E 701 SI <br />City State. <br />Grand Wand hJE <br />Coos <br />68801 <br />Cy <br />Grand Island <br />State <br />NE <br />Zip Cole <br />58801 <br />This Notice of State Tax Llen is issued by the Nebraska Deparinrent of Motor Vehicles for unpaid taxes pursuant <br />to the taws of the state of Nebraska. Notice is hereby given that taxes including penakies and interest nrhkh are <br />shown below, are due from the taxpayer specified above and remain unpaid atter demand. These taxes constitute <br />a hen in the county for real and personal property belonging to the taxpayer or hereafter acquired. <br />F lax ?vow <br />Date <br />Assessment <br />Amount of Tax <br />Peneay <br />interest <br />Add't' <br />Sa+once of <br />Assessment Due <br />2019-4 <br />09/15/2022 <br />$ 1,848.52 <br />$ 185.00 <br />$ 355.94 <br />$ 2,389.46 <br />TOTAL <br />$ 2,389.46 <br />t heresy certify tsat ttta Knbrast;a Department of Motor %snit es nes cornpitedd tate the rewsxre taws 6f the State a, * ebanSxa to the <br />Cetetrexa10' of the anxya t shown to be due. and ted taxpayer has tatted to pat the amwxft doe atter demand 11 thus Notre at State Tax <br />Oen is an extensors of an a recMe ries, a serves to contest` the mionty Cr 7e states interest 6t We affected property 01 ate taxpayer <br />Sign !/tf.. r w:l't j r., x}'(i,,._ Administrative Specialist 04/12/2023 <br />Dat. <br />here :'.•ap1"rr,. s: O'4&+r6 <br />P <br />A-.thys,es Signatvte <br />Tide <br />Program Manager 04/12/2023 <br />rue <br />Dare <br />FOR.0 UNTY OFFICIALS USE J <br />Nebraska Department of Motor Vehicles <br />Motor Carrier Services <br />301 Centennial Mall South <br />PO Box 94729 <br />Lincoln, NE 68509-4729 <br />DMVAccount #863 <br />NEBRASKA DEPAA+2T,1r NT Or MOTOR VTS4 CLOS f2evieled 92.12* <br />• CYV-a823.%S <br />