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Tax Is►og am <br />Tax Period <br />A Det ant <br />Tax <br />Penalty <br />Interest <br />Costa <br />Total Due <br />Individual <br />2012 <br />11/0812014 <br />1,124.00 <br />56.20 <br />122.96 <br />1,303.16 <br />Total <br />$1,303.16 <br />Dec. 8. 2016 2:52PV1 NE Secretary of State — UCC No. 9020 P. 8/3 <br />Nebraska Depareoent 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.Thls lien will expire and <br />become unenforceable 10 years after the data of recording if no <br />continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />Nebueska ID Number <br />96522348 <br />Lien Serial Number <br />11681868 <br />Dale of Lien <br />12/06/2016 <br />sign <br />here Preps <br />Lien Filed With: <br />Register of Deeds ❑ County Clerk <br />Business Name and Location Address <br />ra Signature <br />uthorized Signature <br />201608238 <br />Notice of State Tax Lien <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Federal b Number <br />Social Security Number <br />XXX -XX -2200 <br />Lem Type: <br />® original ❑eorgknrstion Dermot/ad <br />MUGINGI OGISTE <br />620 N NEW BRAUNFELS AVE <br />SAN ANTONIO TX 78244 <br />STL <br />9916793717 —S Pfl: 1 <br />e <br />OGISTE MUGINGI <br />Filed: 12/06/2018 12:51 PM <br />E Sr e of stalls John S e.lr - UCC <br />Spouse's Social Security Nunber <br />aunty <br />HALL <br />Taxpayer Name and Mailing Address <br />I certify that the Nebraska Department of Revenue has complied with the leWs of the Slate of Nebraska In determining the amour shown to be due, <br />and that the taxpayer has bled to pay Re amount due after demand. This Notice of Slate Tan Lien Is an effective ton and serves to continue the priority of <br />States interest In the property of the rah payer. <br />i / <br />• /..L. i Revenue Agent <br />f / <br />1210612016 (402)471 -5713 <br />Title Date Phone Number <br />Revenue Supervisor 12/08/2016 <br />Tile <br />Date <br />44941974 Rev. 6-2019 Supersedes 4946 4974 P.m.2 2002 <br />