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NEEIRA64EA- <br />Good Life. Great Service. <br />-I-- <br />202400347 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2401000686-3 Pages: 1 <br />Debtor Name: DOUBLE LINE AUTO REPAIR LLC <br />Filing Daze and Time: 01/24/2024 08:55 AM <br />Notice of State Tax Lien <br />This Notice of State Tax Lien Is issued by the Nebraska <br />Department of Revenue for unpaid taxer administered by the Tax <br />Commissioner. Taxes, including penalties, interest, and costa, <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 ie recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />PLEASE DO NOT WRITE wags SPACE <br />Nebraska ID Number <br />14001519 <br />Federal ID Number <br />852213151 <br />Lien Serial Number <br />12321211 <br />Lien Fred WIMe <br />neon* of Deeds 0County Pak <br />Social Sectary Number <br />NO SSN <br />Spouse's Social &aaaNy Nttreler <br />NO SPOUSE SSN <br />Daae at Lien <br />January 4, 2024 <br />Lkn TWO: <br />IM Odpilet ['Continuation <br />DCo.ctsd <br />C uMy <br />HALL <br />867.00 <br />Busbies; Name end Location Address <br />Taxpayer Name and Mai ling Address <br />DOUBLE LINE AUTO REPAIR LLC <br />3700 WEST 2ND STREET <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 />Withholding <br />01/01/2022 - 03/31/2022 <br />07/09/2022 <br />5,780.00 <br />867.00 <br />408.57 <br />.00 <br />7,055.57 <br />Withholding <br />04/01/2022 - 06/30/2022 <br />04/16/2023 <br />4,500.00 <br />1,575.00 <br />284,04 <br />.00 <br />6,359.04 <br />Withholding <br />07/01/2022 - 09/30/2022 <br />04/16/7.023 <br />4,500.00 <br />1,350.00 <br />250.01 <br />.00 <br />6,100.01 <br />Withholding <br />10/01/2022 -12/31/2022 <br />04/16/2023 <br />4,500.00 <br />675.00 <br />208.34 <br />.00 <br />5,383.34 <br />Withholding <br />`01/01/2023 - 03/31/2023 <br />08/28/2023 <br />2,730.00 <br />546.00 <br />93.12 <br />.00 <br />3,369.12 <br />Total <br />28,267.08 <br />t oertOp that the Nebraska Department at Hoene has complied wth the Ina Of gm Stets of Nebraska in dsiennhrig the amount shown Ss be duo <br />and shat the taxpayer has felled to pay the amount due ater demand. 7Ne Notice of Sate Tex Lien is an effective ten and serves to continue the priority of <br />the States interest In the effected property of the taxpayer. <br />Sign p <br />here <br />sign, <br />pier.''_ <br />Revenue Senior Agent 12/2812023 402-471-6067 <br />rare <br />Revenue Supervisor <br />Phone <br />f22/ZQ24 <br />Title <br />Oats <br />4.494.1e14 Per 1-20:0 &weaved» 4 -e49 -1e74 nee e:to1e <br />