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Good Life. Great Service. <br />202401954 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2405000081-0 <br />Debtor Name: KRISTIN COVERT <br />Filing Date and Time: 05/01/2024 10:40 AM <br />Pages: 1 <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 lien -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 DO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />96662662 <br />Federal D Number <br />NO FEIN <br />Lien Serial Number <br />12470002 <br />lien Red With: <br />arj Rea r of Deeds ©Cour* Cwdt <br />Soda1 security Number <br />XXX -XX -6475 <br />Spouse's Social. Security Number <br />NO SPOUSE SSN <br />Date of lien <br />April 23, 2024 <br />Lin Type: <br />($j Original ©Continuation <br />01/18/2022 <br />County <br />HALL <br />■ Corrected <br />Business Name end Location Address <br />sxpayer <br />KRISTIN COVERT <br />4979 COFFELT LN <br />JOPLIN MO 64804 <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 />01/18/2022 <br />$350.74 <br />$28.00" <br />$69.60 <br />$448.34 <br />Total <br />$448.34 <br />sign <br />here <br />1 certify that the Neb .aka Department of Revenue has complied with the laws of the State of Nebraska In determining the amount shown to be due. <br />endat the fa the amount due elks-dernand.Tht$ Notice of Store Tax Lien la an effective lien and serves to continue the priority of <br />/ r , <br />11M + :. i �+ d1e ,{wti li. •.riy of the taxpayer. <br />Prep -'.ism.. <br />onusd Signatu <br />Revenue Agent 04/23/2024 (402)4471-0987 <br />Title Date Phone Number <br />Revenue Supervisor® 04/23/2024 <br />lilt. Date <br />e-At•1YN nes &sots 0,gretlw 444a-1174 Arm e-2013 <br />