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Tax <br />Program <br />Tax Period <br />Dehr <br />nti inMet <br />Tax <br />Penalty <br />Intermit <br />Coate <br />Tout Doe <br />Individual <br />2012 <br />01/14/2014 <br />786.00 <br />30.30 <br />44.45 <br />809.75 <br />Total <br />S880.75 <br />Mar. 11. 20i5 3:16'M NE Secretary of State — UCC No, 9603 <br />Neare6M1 t eanneme of <br />REVENUE <br />Lien Stull Number <br />11947937 <br />chse Mum <br />03104/2015 <br />sign <br />here <br />Sieniture <br />Lien riled WW : <br />negeper of fete ❑ coin'y Dirt <br />Lleil �; <br />® moot <br />Business Name and Location Address <br />201501486 <br />Notice of State Tax Lien <br />This Nonce of State Tax Lien is issued by the Nebraska <br />bapurtment of fk venue for unpaid seem adminLatorod by tlto1 <br />Commissioner. Taxes, including penalties, interest, and casts, <br />which are shown below, are due front the taxpayer and remain <br />unpaid afterdemsnd.Tiese taxes area lien for all properly located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the aspiration of this Nan. T111e lien will empire and <br />beooms unerdoroeable 10 years alter the date of reoordirlp If no <br />continuation statement to recorded on or prior to the expiration of <br />the previous ben or continuation statement. <br />maraca K1 Nurtrar <br />86113243 <br />❑ canaieteam ❑eorsepea <br />PLEASE CO NOT WRTE IN THIS SPACE <br />Federal ID Nolen <br />ScOileeoudri Number <br />XXX-XX4143 <br />County <br />HALL <br />Taxpayer Name and Nailing Address <br />PEDRO SUAREZ CONCEPCION <br />1002 W JOHN ST <br />GRAND ISLAND NE 66801 <br />mx 1 .i Stale John A e.1. - UcC eTL <br />881575•233-I Pest 1 <br />SUAREZ CONCEPGION PEDRO <br />Filed: V 11/21111 111:511 PM <br />Spouse's Said Security Rueter <br />Inertly that the Nebula Oeflattnaa or Demme has Conrpied rilh to le en at the Slaw al riebeasks In MenWNnp the Emoted shown m be due, <br />aM K1e taxpayer has tiled b poly tta amount dm after L1t Noire of $t to Tex taut Is an OM Kin and eettes b tanelale Ole priaray of <br />the interest in the domed property al the exprpr. <br />0310412015 21/71 -5712 <br />Dale Phone Rue* <br />Revenue Supervisor 031042015 <br />Date <br />&m ia7/ nee 1401aSominsoer 444El14 nn.aaooe <br />