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201607106
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Last modified
10/25/2016 3:58:10 PM
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10/25/2016 3:58:10 PM
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DEEDS
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201607106
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Pr gram <br />Tax Period <br />X 9 <br />Tax <br />Penally <br />Meteor <br />Costs <br />Total Due <br />Individual <br />2011 <br />07/22/2014 <br />304.00 <br />76.00 <br />45.56 <br />425.56 <br />Total <br />$425.66 <br />Oct, 25. 2(16 2:23FM NE Secretary of State — UCC <br />Nebraska Department 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 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.This Ilan 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 />47576030 <br />Lien Serial Number <br />11679321 <br />Dale of Lien <br />10/21/2016 <br />Business Name and Location Address <br />Notice of State Tax Lien <br />Lien Filed Wier <br />© Register of Deeds ❑ County Clerk <br />Title <br />Federal ID Number <br />Social Security Number <br />XXX -XX -3220 <br />Wen Type; <br />g J Original ❑ continuation ❑Corrected <br />VICTOR H HERNANDEZ <br />2117 W CAPITAL AVE 13 <br />GRAND ISLAND NE 68801 <br />Revenue Agent <br />TRW <br />Revenue Supervisor <br />NQ S.c of Sie <br />PLEASE DO NOT WRITE IN THIS SPACE <br />9916781754 -1 Pot: 1 <br />HERNRNDEZ VICTOR 14 <br />Filed: 10/26/2016 09:1e AM <br />Spouse's Social Security Number <br />County <br />HALL <br />Taxpayer Name and Mailing Address <br />]ohn a 6�1a - ucE OIL <br />A HIT1 <br />I certify that the Nebraska Department of Revenue has complied with the laws ol the Stale of Nebraska In determining the amount shown lo due, <br />and that the taxpayer has fated to pay the amount due alter demand. This Notice of State Tax Uerf Is an effective ten and serves to continue the priority of <br />the State's irderest in the affected property of the taxpayer. <br />10/2112016 (402)471 -5712 <br />Dale Phone Number <br />10/21/2016 <br />Date <br />4- 494 -1971 Res e.2013 Supersedes 4-9191974 flee 2 -2002 <br />
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