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Good tie. Great Saran. - <br />202402033 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2405000233-1 Pages: 1 <br />Debtor Name: SHANDI HARTWIG <br />Filing Date and Time: 05/07/2024 09:08 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 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 MUTE IN THIS SPACE <br />Nebraska to Number <br />43100570 <br />Federal 10 Number <br />NO FEIN <br />Lan Serial Number <br />12470958 <br />lien FiladNAM: <br />Social Security Number <br />XXX.XX.6983 <br />Spouse's Sociel Sacority Number <br />NO SPOUSE SSN <br />1.4 Register of Deeds • County Clerk <br />Date of lien <br />May 1, 2024 <br />Len type: <br />Jorgmu ©Continuation ❑Corrected <br />County <br />BALL <br />Business Name and Location Address <br />axpayer <br />SHANDI HARTWIG <br />508 CONEFLOWER <br />GRAND ISLAND NE 88803 <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 />11/03/2023 <br />$3,530.53 <br />$244.98 <br />$185.48 <br />$3,960.99 <br />Total <br />$3,960.99 <br />sign <br />here <br />I certify that the Nebraska Department of Revenue hes compiled with the laws of the Stale el Nebraska In determining the anoint shown ta be due, <br />and that the taxpayer baa failed to pay the amount due after demand,This Notice of Stale Tax Lien Is art ePsskve hien and serves to continue the priority of <br />'a Interest in he a property of the taxpayer. <br />Merged Signature <br />Revenue Senior Agent 05/01/2024 (4021471-4339 <br />TMs Date Phone Number <br />Revenue Supervisor 05101/2024 <br />Title Date <br />4.454.1974 Rim &2MMe Boperman 4444.1574 Rev. &2013 <br />