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202405568 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2411000129-0 Pages: 1 <br />Debtor Name: CORY FULTON <br />Filing Date and Time: 11/04/2024 10:33 AM <br />Goodt.a.GreatSwam <br />1110/NIIMKOPIIIIMPAII <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 end remain <br />unpaid after demend.Thas 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 10 years after the date of recording if no <br />continuation statement Is recorded on or prior to the expiration of <br />the previous lean or continuation statement. <br />PLEASE DO MOT WRITE IN THIS SPACE <br />Natxaakam ID Number <br />361349309 <br />Wool <br />NO FEIN <br />1) Nu tber <br />LNn setaf Numbw <br />12489718 <br />Lien RedWeh: <br />(jj Rom, sow% Do/C <br />Social esourty Number <br />XXX-XX-0481 <br />apowde Bail Beauty Number <br />NO SPOUSE SSN <br />Dams oft an <br />October 17, 2024 <br />—LW llpe: <br />Wawa ❑ El Corroded <br />County <br />HALL <br />1 m. _t__ . u .._ <br />_ , ...•e.. e.r t... • T .,....... <br />u........../ Ra.tlr.... a.e.t,... <br />I <br />CORY FULTON <br />320N1ST APT 34 <br />DONIPHAN NE 68832 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />tax <br />Penally <br />Interest <br />Costa <br />Total Due <br />Individual <br />2017 <br />01/27/2024 <br />$1,634.00 <br />$408.50 <br />$443.42 <br />$2,485.92 <br />Individual <br />2018 <br />0127/2024 <br />$1,164.00 <br />$116.40 <br />$25720 <br />$1,537.60 <br />Indhidual <br />2019 <br />01/27/2024 <br />$2,951.00 <br />$737.75 <br />$510.57 <br />$4,199.32 <br />Total <br />$8,222.84 <br />I cattily the the Nebula Department al Revenue has compared wilt the bre Of the ties of Nsbrasla a determining the euomt stout to be due, <br />and that Ow tatmer has faced to pay the mount due sex dseend. TIN Noire of Stela lax U n le en den a Pen and sense lo condom the pdndty of <br />the Math hdsre0In the aided mealy a the taxpayer. <br />sign 6 7h <br />here r <br />Authorized Stratum <br />RevenuQ •,aqr <br />TBM <br />10/172024 (308)63-1208 <br />Dale Phone Number <br />e41. ,tirt.4� Revenue Supervisor 10117/2024 <br />Tee Data <br />4retlNehot MIS alpSUsdts44w1eiePea 4401e <br />