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PM <br />Program <br />Tex Period <br />Date or <br />Assessment <br />Tax <br />Penalty . <br />Interest <br />Costs • <br />Total Due <br />Individual <br />2011 <br />02/01/2013 <br />732.00 <br />36.80 <br />89.25 <br />857.85 <br />Total <br />$857.85 <br />Nov. 19. 2015 2:57PM NE Secretary <br />Nebraska beeartment of <br />REVENUE <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 area lien for all property located <br />in the county and rights to properly owned by the taxpayer or <br />acquired before the expiration of this lien.This 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 Ilan or continuation statement, <br />Nebraska ID Number <br />37331728 <br />Lien Serial Number <br />11561311 <br />Date of Lien <br />11/16/2015 <br />sign <br />here <br />zed Signature <br />Notice of State Tax Lien <br />Gen Ftadwth: <br />® Register of Deeds p County Clerk <br />13uslness Name and Location Address <br />Preparef- alum <br />of S t a t e V V V NE Soe N o 3682,,,„ p 2 LLC STL <br />9 9 15 764149 -5 • P9s! 1 <br />Filed: 11RNgD2015R01:23 PM <br />201507972 <br />Gen Type: <br />® odyriaa ['Continuation 0 Corrected <br />Title <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Federal o Number <br />Social Security Number <br />XXX-XX-3374 <br />ANIDO PEREZ SILIESAR <br />2608 W 1ST <br />GRAND ISLAND NE 68803-4227 <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />Spouse's Social Security Number <br />County <br />HALL <br />Taxpayer Name and Mailing Address <br />I certify that the Nebraska Depart of Revenue has complied with the laws of the State of Nebraska In determining the amount shown to be due, <br />and that the taxpayer has felled to the amount due after demand, Ibis Notice of State Tax Llen Is an efteclfve lien and serves to continue the priority of <br />the State y est In the ahe , roomy of the taxpayer. <br />11/16/2015 (402)471 -6043 <br />Date <br />Phone Number <br />11/16/2015 <br />Data <br />4494-1974 Res 8-2013 Supersedes 49991974 km 54=2 ,( <br />