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TeX <br />Program <br />Tax Period . <br />Date or <br />Assessment <br />Tait <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2012 <br />06/25/2013 <br />536.00 <br />26.80 <br />4322 <br />806.02 <br />Total <br />$606.02 <br />D .28. 2015 3,51F'M NE B retary f tat? — UCC No. 4295:5T�P. <br />„� Sec of !l�e� John <br />�.Oi <br />9 -2 <br />s, t <br />MORQDa 91575 REYNL7841i�m50EN Pg <br />57 PI'I <br />Nebraska D608ftM6er of <br />REVENUE <br />Nebraska 10 Number <br />95430504 <br />Lien Serial Number <br />11562853 <br />Date of Lien Lien Type: <br />12/22/2015 ® original ❑continuation <br />sign <br />here <br />Business Name and Location Address <br />Pre <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 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 lien or continuation statement. <br />Lien Fled With: <br />IN Register of Deeds ❑ County Cleric <br />Revenue Agent <br />Title <br />PLEASE DO NOT WAITE IN THIS SPACE <br />Federal ID Number <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />Social Security Number <br />XXX XX -071 <br />REYNALDO MORENO MORADO <br />120 W KOENIG <br />GRAND ISLAND NE 68801 <br />Tine <br />Revenue Supervisor <br />Spouse's Social Security Number <br />County <br />Corrected HALL <br />Taxpayer Name and Mailing Address <br />I cenity Iftat the Nebraska, Department of Revenue hers complied with the laws f the State of Nebraska In determining the amount shown to be due, <br />and Ural the taxpayer has failed . he nt due alter demand. This.Nollce of Stale Tax lien fs an effective lien and serves to continue the priority of . <br />. the State's int= =st in the ailed =:1k ry of re Iaxpaypt'1 <br />�tE17. it <br />..., .,,,. , ;VW <br />A4 A <br />Aug ...ad ' ir <br />12/2212015 (308)632 -1206 <br />Date " Phone Number <br />12/22/2015 <br />Date <br />4.494.1974 Pelt 6.2013 9uperse lea 4.948.1674 flay. 2 <br />