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202501841 NE Sec of State - Robert B. Evnen Filing Document #: 2504000378-3 Pages: 1 Debtor Name: HAYAT H HASSAN Filing Date and Time: 04/11/2025 10:57 AM Good Lila Groat Service. Notice of State Tax Lien This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes administered by the Tax Commissioner. Taxes, including penalties. interest, and costs, which are shown below, are due from the taxpayer and remain unpaid after demand.These taxes ere a lien for all property located in the county and rights to property owned by the taxpayer or acquired before the expiration of this lien.This lien will expire and become unenforceable 10 years after the date of recording if no continuation statement is recorded on or prior to the expiration of the previous lien or continuation statement. PLEASE DO NOT WRITE IN THIS SPACE Woman ID Nmber 90283542 Federal ID Nrtber NO FEIN Uon SwiN Nsentre 12502003 Uen Feb ovate ) ns4s* of De.du © may chwk SoeW Seaway Nanber XXX-XX-8f188 Spouse's Social Sea" Number NO SPOUSE SSN Dale of Lien March 25, 2025 Lbn Type: j$Jorgaw 0conenuason ❑Conscrd nth HALL Business Name and Location Address payer Name and mailing HAYAT H HASSAN 311 N LINCOLN AVENUE APT 8 GRANO ISLAND NE 88801 Tax Program Tax Period Date of Assessment Tax Penalty Interest Costs Total Due Individual 2022 11/03/2023 $322.56 $125.55 $118.35 4568.46 individual 2023 05/07/2024 $1,435.00 $88.75 $77.53 $1,801.28 Total $2,187.74 I certify that to Nebraska Department or Rasmus but complied with the Iwo at the SUN of NebrMs in deWrnk*p the amount shown is be due, and Mel the lerpeysr hes hied w pm, the strew* dime dor demand TNa Nuke of enema Urn Man Wauw lien end serves O centime the priority of the Steb1 ederest in the eseetsd peppy or tie lanPorrit sign here 1 if4 L huthwized Signature Revenue Senior Agent 03/25/2025 (308)8332-2272 Tido D.e. Phone Number Revenue Supervisor 03/25/2025 Tide Deis 4410,1e74 Plotsate impends* 4.e44107t Plm filet$