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202501230 <br />NE Sec of State - Robert B. Evnen <br />Filing Document 14: 2503000500-1 <br />Debtor Name: WILLIS WORKWEAR LLC <br />Filing Date and Time: 03/11/2025 09:54 AM <br />Pages: 1 <br />Good life. Great Service. <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 flen.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 lien or continuation statement <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Nebeaska ID Number <br />12683/67 <br />Federd ID Number <br />814289230 <br />Lien Send Number <br />12529061 <br />Lien reed Wtt% <br />j eer of Deeds ❑ Carl*/ CAM <br />SOCill Security Number <br />NO SSN <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />Dot of Derr <br />February 25, 2025 <br />Liem'Nva: <br />County <br />HALL <br />sa...r . w.w..S. 1 <br />r l Original ❑C«rw"mbor <br />• <br />— __ _-__ .._..__ -_.. <br />Business Name and Locetfon Address <br />WILLIS WORKWEAR LLC <br />2621 BRAHMA ST <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Sales <br />03/01/2022 - 07/31/2022 <br />11/15/2022 <br />.00 <br />222.50 <br />43.88 <br />.00 <br />266.38 <br />Sales <br />01/01/2023 - 04/3012023 <br />07/22/2023 <br />.00 <br />160.00 <br />49.18 <br />.00 <br />209.18 <br />Sales <br />05/01/2023 -08/31/2023 <br />11/27/2023 <br />153.96 <br />162.00 <br />43.10 <br />.00 <br />359.06 <br />Sales <br />09/012023 - 04/30/2024 <br />08/10/2024 <br />690.00 <br />219.00 <br />38.35 <br />.00 <br />947.35 <br />Total <br />1,781.97 <br />sign <br />here <br />I certify that the Nebraska Department of. Revenue has compiled with the taws of the State of Nebraska in determining the amount ehown to be due. <br />and that the taxpayer hes faked'. to pay the amount due Mier demand This Notice of Stare Tex Urn is an effective lien and nerves to continue the priority or <br />the States Intents! in the aaected property of the taxpayer. <br />Revenue Aeent <br />Tait <br />Revenue Manager <br />Authorized Stgnttor�--"' ! Title <br />02/25/2025 308-535.8294 <br />Dias Phone Number _..— <br />4d641el4new. aaoia Supaeedas weselax Pen i-Saa <br />