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REEIRASKA- <br />Good Life. Great Service. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2405000072-2 Pages: 1 <br />Debtor Name: HOLLY 3 SCHULTZ <br />Filing Date and Time: 05/01/2024 10:32 AM <br />2 <br />Notice of State Tax Lien <br />Thls 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, ars 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 Iien.Thls lien will expire and <br />become unenforceable td 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 DC NOT WRITE IN THIS SPACE <br />Nebreexa 10 Number <br />95877394 <br />Federal 0 Number <br />NO FEIN <br />U.n Serial Number <br />12469625 <br />Lien Fled With <br />® %gist•ro1Deeds OCourgy Clerk <br />Somal Security Number <br />XXX -XX -4856 <br />Spouse's Sod. Security Number <br />NO SPOUSE SSN <br />Dale of Lien <br />April 19, 2024 <br />Uen'type: <br />® Original 0 CoMinualion ❑ Corrected <br />County <br />HALL <br />usiness Nerne and Location Address <br />expayer Name end Malting Address <br />HOLLY J SCHULTZ <br />3608 SCHROEDER AVE <br />GRAND ISLAND NE 68803 <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 />2022 <br />11/01/2023 <br />$1,927.00 <br />$96.35 <br />$97.67 <br />$2,121.02 <br />Total <br />$2,121.02 <br />sign <br />here <br />I certify that the Nebraska Department M Revenue has complied with the taws of the State of Nebraska In determining the amount shown to be due, <br />and that the taxpayer has faded to pay the amount due afar demand. This Notice of State Tax Lien is /ineffective Fon and serves to continue the priority of <br />the State's interest in the affected property of the t188871781% <br />// Revenue Aaent 04/19/2024 (402)471-5788 <br />ProposesSipneture / Tula Data Phone Number <br />! Revenue Supervisor 04/19/2024 <br />AM'r Signe Tito Date <br />4484.1471 itev 0.2018 Stpawedsa44404a74 flew 84013 <br />