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,E1314, TJR7F <br />Gaol Lite. Great Service. <br />OeWlrWer M Oe Nwu, <br />202306388 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2312000239-6 Pages: 1 <br />Debtor Name: ROBERT H BAILEY <br />Filing Date and Time: 12/07/2023 12:44 PM <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 nen-This lien will expire and <br />become unenforceable 10 years after the date of recording H 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 SI THIS SPACE <br />Nebraska ID Number <br />34268294 <br />Federal <br />NO FEIN <br />0 Number <br />Lien Serial Number <br />12354580 <br />Lien Filed wAh: <br />Social Security Number <br />xxx Xx-6961 <br />Spouse's Social Security Number <br />XXX -XX -7808 <br />i:i Register of Deeds ■ County Clerk <br />Date of Lien <br />December 5, 2023 <br />Uen'iype: <br />®ods ❑Corwnuanw, ['corrected <br />County <br />HALL <br />us nes, Name and Location Address <br />Taxpayer Name and Mailing Address <br />ROBERT H BAILEY <br />LISA BAILEY <br />51 PONDEROSA DR <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 />Individual <br />2019 <br />03/07/2023 <br />53,803.00 <br />$950.75 <br />$492.83 <br />$5,246.58 <br />Individual <br />2020 <br />03/07/2023 <br />$2,546.00 <br />$692.50 <br />$242.32 <br />$3,480.82 <br />Total <br />$8,727.40 <br />I certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska in determining the amount shown to be due, <br />and that the taxpayer fres failed to pay the amount due air demand. This Notice of State Tax Uen Is an effective lien end serves to continue the prte,Hy of <br />the State's interest In the effected property of the taxpayer. <br />Revenue ACent 12/05/2023 (402)471-0987 <br />Title Date Phone Number <br />Revenue Supervisor 12/05/2023 <br />Tse Date <br />4.4e4-1674 Rev. 64018 Safafedes 4449 -tale RRs.&2013 <br />