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NLE1GSpEY'T.7KA- <br />Gard Life, Great Service. <br />Arnwsre.T W <br />WOW( <br />202302958 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2306000343-7 <br />Debtor Name CHRISTOPHER M CEMPER <br />Filing Date and Time: 06/14/2023 10:09 AM <br />Pages: 1 <br />Notice of State Tax Lien <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 />34309993 <br />Federal D Number <br />NO FEIN <br />Llan Serial Number <br />12335034 <br />Lain Filed WI 1f1: <br />Social Security Number <br />XXX -XX -1594 <br />Spouses Social Security Number <br />NO SPOUSE SSN <br />4 Register of Deeds ❑County Clerk <br />Date of Lien <br />June 7, 2023 <br />Llen type: <br />[Corrected <br />County <br />HALL <br />11 original ❑Continuation <br />usiness Name and Location Address <br />Taxpayer Name and Mailing Address <br />CHRISTOPHER M CEMPER <br />13251 W SCHULTZ RD <br />WOOD RIVER NE 68883 <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 />2010 <br />05/04/2011 <br />$32.55 <br />$6.55 <br />$16.86 <br />$55.96 <br />Individual <br />2018 <br />12/01/2022 <br />$897.00 <br />$89.70 <br />$137.00 <br />$1,123.70 <br />Total <br />$1,179.66 <br />sign <br />here <br />I certify that. the Nebraska Department of Revenue hes complied with the laws of the State of Nebraska In determining the amount shown lobe due, <br />and that the taxpayer has failed to pay the amount due after demand. This Notice of State Tax Lien Is an affective lien and serves to continue the priority of <br />the State's interest In the affected property or the taxpayer. <br />F1'eperet's Signature <br />orized Signetu <br />Revenue Aient <br />Title <br />Revenue Supervisor <br />06/07/2023 (402)471-5788 <br />Date Phone Number <br />06/07/2023 <br />Tide Date <br />4.414.1974 Res. &2018 Supersedes 4-949-1974 Rev, 14013 <br />