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NEBRA644A- <br />Good Life. Grist Service. <br />•.1.0Ttwr.. •fwMwa <br />202402854 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2406000605-3 Pages: 1 <br />Debtor Name: SUTRISNO SUTRISNO <br />Filing Date and Time: 06/24/2024 11:30 AM <br />Notice of State Tax Lien <br />Thla 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 ilea for ail property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this tien.This lien will expire and <br />become unenforceable 10 years after the data 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 00 NOTwwTE IN IS SPACE <br />Netuesks ID Nurtilar <br />48597800 <br />Fedm$i <br />NO FEIN <br />D NI%M19r <br />Sural Nunttaet <br />124762401 <br />talar Fred %Wh: <br />SodN Seaatty Number <br />XXX -XX -1984 <br />Spoue9"a Soolil t3ewfily t4unybea <br />NO SPOUSE SSN <br />/4 sterol needs OCountyol.rk <br />Cti1% of 11er1 <br />June 17, 2024 <br />limp Tyf,e: <br />0co+..dae <br />Gbonty <br />HALL <br />2:t fNipns 0Conenusdon <br />Business Na <br />and <br />on Address <br />axpaysr Name and MalUnp Addross <br />SUTRISNO SUTRISNO <br />1206 CEDAR RIDGE CT APT 101 <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 />Ind' fvidual <br />2019 <br />11/29/2022 <br />$906.00 <br />$45.30 <br />$141.61 <br />51,092.91 <br />Total <br />$1,092.91 <br />sign <br />here <br />1 caddy that the Nebraska Department d Resere ham canted wet the lava d Lir Stele d Nebraska In delermkanp the *mount damn to W due, <br />and that the taxpayer hes fatted lo pay the amount due after demand. This Moate of State Tax Lien Is en ONO.* sea end came s4- continue the pdodty el <br />111e Stalk Interest in the ebared property d kw taxpayer. <br />Peparar's Signature <br />Signe <br />Revenue Agent 08/17/2024 (402/471-5928 <br />The - oas Phone Number <br />Revenue Supervisor 06/17/2024 <br />Title Cela <br />4440074 Not did* theansdee 4-045.1914 Ret 8404 <br />