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Tax Program <br />Tax Period <br />Assess ° mo t <br />Tax <br />Penalty <br />Interest <br />Goats <br />Total Due <br />Individual <br />2010 <br />03/27/2013 <br />175.00 <br />8.75 <br />32.55 <br />216.30 <br />L <br />• <br />Total <br />$216.30 <br />May. 4. 2016 2:59PM NE Secretary o f State — UCC N o. 6352 P. 2 <br />NE See of S4afe John A Sala - UGC 6 TL <br />11 1111 <br />9916773234 -t • Pea: <br />cHRVEZ ROOOLFO <br />Filed: 05/04/2016 01:44 PA <br />NebrasNe Deparsmem of <br />REVENUE <br />Date of Lien <br />05/03/2016 <br />Business Name and Location Address <br />201 <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 iien.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 />Nebraska ID Number <br />36026379 <br />Lien Serial Number <br />11670007 <br />Lien Filed With: <br />Register al Deeds ❑ County Clefk <br />Original ❑Continuation ❑Corrected <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />The <br />PLEASE DO NOT WHITE IN THIS SPACE <br />Federal ID Number <br />Social Security Number <br />XXX -XX -8185 <br />RODOLFO CHAVEZ <br />GUADALUPE NAVA VILLA <br />PO SOX 837 <br />GRAND ISLAND NE 68802 <br />Spouse's Social Security Number <br />County <br />HALL <br />Taxpayer Name and Mailing Address <br />• <br />1 certify that the Nebraska Department of Revenue has complied with the laws of the Slate of Nebraska in determining the amount shown to be due, <br />d that the =r has failed to pay the . nt due attar demand. This Notice of State Tay Llen Is an effective den and serves to continue the priority of <br />ale's in the y ted props taxpayer. <br />05/03/2016 (402)471 -5731 <br />Date Phone Number <br />05/03/2016 <br />Data <br />a.Cat474. Rev .8.20'r9 supesales 4- 949.1974 Rev. 2-2002 <br />