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Good L:fe. Great Service <br />202303081 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2306000478-2 Pages: 1 <br />Debtor Name: PHILLIP J LUHN <br />Filing Date and Time: 06/21/2023 09:55 AM <br />Notice of State Tax Lien <br />Ar <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, end 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 0 no <br />continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />Nebraska ID Number <br />34395768 <br />Lien Serial Number <br />12335723 <br />PLEASE DO NOT WRITE IN THIS SPAC <br />D Number <br />NO FEIN <br />en Flied <br />rot Deeds ID County Clerk <br />Social Security Number <br />XXX -XX -9074 <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />Date of L ten <br />June 13, 2023 <br />Lien <br />e <br />© Continuation 0 Corrected <br />Taxpayer Name and Mailing Addres <br />PHILLIP J LUHN <br />654 FAIDLEY PLACE <br />APT 3 <br />GRAND ISLAND NE 68803 <br />County <br />HALL <br />usiness Name and Location Address <br />I certify that the Nebraska Department of Revenue has compiled with the laws of the State of Nebraska in determining the amount shown to be due <br />and that the taxpayer has tailed to pay the amount due alter demand. This Notice of State Tax Lien is en effective Ilan and serves to continue the priority of <br />the Slate's interest In the affected wooed), of the taxpayer. <br />sign Wit,, 7y , L Revenue Agent 06/13/2023 (308)632-1210 <br />here Prepare,' nature title Date fine Number <br />.614% A.1.064 Revenue Supervisor 06/13/2023 <br />Authorized Signature Tido Date <br />4.494.1974 Box 8-201a Supersede. 44494574 Rev 5.2015 <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 />08129/2022 <br />$566.00 <br />$141.50 <br />$132.42 <br />$839.92 <br />Total <br />$839.92 <br />I certify that the Nebraska Department of Revenue has compiled with the laws of the State of Nebraska in determining the amount shown to be due <br />and that the taxpayer has tailed to pay the amount due alter demand. This Notice of State Tax Lien is en effective Ilan and serves to continue the priority of <br />the Slate's interest In the affected wooed), of the taxpayer. <br />sign Wit,, 7y , L Revenue Agent 06/13/2023 (308)632-1210 <br />here Prepare,' nature title Date fine Number <br />.614% A.1.064 Revenue Supervisor 06/13/2023 <br />Authorized Signature Tido Date <br />4.494.1974 Box 8-201a Supersede. 44494574 Rev 5.2015 <br />