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NEBRASKA- <br />Good <br />EB R7Y.cdK7 <br />Good Life. Great Service. <br />OOMOtwNTN 04.144 <br />2077)0637 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2312000142-1 Pages: 1 <br />Debtor Name: MELVIN BRAHATCEK <br />Filing Date and Time: 12/06/2023 08:57 AM <br />Notice of State Tax Lien <br />This Notice of State Tax Uen 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 area Nen for all property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this Iien.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 D0 NOT WRITE ltd THIS SPACE <br />Nebraska 10 Number <br />40519635 <br />Federal 10 Number <br />NO FEIN <br />Uen Serial Number <br />12354117 <br />Uen Filed cadre <br />® Register of Deeds ❑ County Clerk <br />Social Security Number <br />XXX-XX•5436 <br />Spouse's Sockd Securky Number <br />NO SPOUSE SSN <br />Date of Lien <br />November 29, 2023 <br />Lien Type: <br />❑Corrected <br />County <br />HALL <br />L1 CAigirw ■ Continuation <br />Business Name and Location Address <br />Taxpayer Name and Naffing Address <br />MELVIN BRAHATCEK <br />4056 DAVID AVE <br />GRAND ISLAND NE 68803 <br />Tex Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2018 <br />01/09/2023 <br />$4,276.19 <br />$354.20 <br />$871.16 <br />$5,501.55 <br />Total <br />$5,501.55 <br />I certify that the Nebraska Department of Revenue has complied with the laws of the Stats all Nebraska In determining the amount shown N be due. <br />and that the taxpayer has faded to pay the amount due after demand. The Notice of Slate Tax Uen ts an efeedva Ben and serves to continue the priority of <br />the Slab's Interest in the affected property of the taxpayer. <br />sign a A <br />here IF Repartua&Stratum <br />Authorized Signature <br />Revenue Agent <br />TRIO <br />11/29/2023 (308)632-1206 <br />Date Phone Number <br />Revenue Supervisor 11/29/2023 <br />rife Cele <br />4.404/910 R6% 6.2016 Bupersedas 4-0494014 A6%112018 <br />