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NFBPA&34-A., <br />Liecci LE% Great Ser,t4. <br />ee...,e.waa.»r..epr <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2305000610-7 Pages: 1 <br />Debtor Name: GRANT T SEEBER <br />Filing Date and Time: 05/17/2023 09:27 AM <br />Notice of State Tax Lien <br />202302399 <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 llen.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 00 NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />11326697 <br />Federal ID Number <br />455322482 <br />Lien Serial Number <br />12316441 <br />Lien Flied With: <br />Social Security Number <br />XXX -XX -5272 <br />Spouse's Social Security Number <br />i7 Register of Deeds ❑ COO rm;cierk <br />Date W Lien <br />May 5, 2023 <br />Lien Type: <br />❑Cow reded <br />County <br />HALL <br />Original ❑Continuation <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />GRANT T SEEBER <br />DrB/A TIM SEEBER JANITORIAL SERVICES <br />1010W9TH ST <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 />Sales <br />01/0112019 - 12/31/2019 <br />05/16/202(1 <br />.00 <br />315.75 <br />175.59 <br />.00 <br />49L34 <br />Sales <br />01/01/2020 - 12/31{2021 <br />08/07/2022 <br />3,460.14 <br />790.00 <br />229.21 <br />.00 <br />4,479.35 <br />Total <br />4,970.69 <br />1 certify that the Nebraska Department of Revenue has corcpiied with the laws of the Slate of Nebraska in determining the amount shown to be due, <br />and that the taxpayer has failed to pay the amount due atter demand. This Notice of State Tax Lien is an effective lien and serves to continue the priority of <br />the Stales interest in the affected property of the taxpayer. <br />sign k ,u,„ozc <br />here r Preparees Signator®.< <br />Authorized Signe ier§ f Title <br />Revenue Agent <br />05/05/2023 402-471-5717 <br />Title <br />Revenue Supervisor <br />Date <br />Phone Number <br />i-XOPiefd 7-3 <br />Date <br />4.4ewreve few a•2018 Supersedes 49494/974 Rev. a-zo13 <br />