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201707387
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10/30/2017 3:58:02 PM
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10/30/2017 3:58:02 PM
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DEEDS
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201707387
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l <br />Oct. 30. 2017 3:13FM NE Secretary of Stag — UCC <br />oz77 <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 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 Ilen or continuation statement. <br />Nebraska ID Number <br />96524782 <br />Lien Serial Number <br />11796296 <br />Date of Lien <br />October 25, 2017 <br />Tax Program <br />Individual <br />Lien Filed With: <br />® Register of Deeds <br />Lien Type: <br />® Original <br />Business Name and Location Address <br />Tax Period <br />2015 <br />Notice of State Tax Lien <br />Date of <br />Assessment <br />05/08/2017 <br />county Clerk <br />❑ Continuation <br />Tale <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Federal D Number <br />Social Security Number <br />XXX -XX -7632 <br />Tax <br />$578.00 <br />Revenue Agent <br />Tilte <br />Revenue Supervisor <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />❑ Corrccled <br />Taxpayer Name and Mailing Address <br />FRANCISCO LUCAS OSORIO <br />215 E 7TH STREET <br />GRAND ISLAND NE 68801 <br />Penalty <br />$28.90 <br />NS sac et C4e4. John 11 dale - u[G STL <br />. l <br />111 <br />w ; <br />99178efa1® -7 Pas 1 <br />OSORIO FRANCISCO LUCAS <br />Filed: 10/30/2017 09:45 AM <br />Spouse's Social Security Number <br />county <br />HALL <br />Interest <br />2 012748 7 S 9)12 <br />$26.51 <br />10/25/2017 <br />Date <br />Costs <br />Total <br />1 certify that the Nebraska Department of Revenue has complied with the laws of the Stele of Nebraska In determining the amount shown 10 be due, <br />and that the taxpayer has lai =. • + y ' _ = ounl due after demend.This Notice of Slate Tax Lien is an effective Men and aeries to continue the priority of <br />the State's Interest in the a the <br />Total Due <br />633.41 <br />$633.41 <br />(308)632 -1206 <br />Phone Number <br />10/25/2017 <br />Date <br />4.494.1974 Rev. 8-2013 8upersettee 4949 -1974 Rev. 2 - 2002 <br />
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