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Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2013 <br />04/26/2016 <br />$441.00 <br />$22.05 <br />$47.52 <br />510.57 <br />Total <br />$510.57 <br />Nov.25. 2517 4:11FM NE Secretary of State — UCC <br />Nebreeka 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 lien.This lien will expire and <br />become unenforceable 10 years alter 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 />46430512 <br />Lien Serial Number <br />11797575 <br />Date of Lien <br />November 16, 2017 <br />Business Na <br />sign <br />here <br />. <br />re ; Signature <br />,7- <br />Notice of State Tax Lien <br />Lien Filed With: <br />Register of Deeds 0 County Clerk <br />Lien Type: <br />® Original []Continuation <br />me and Location Address <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Federal ID Number <br />Social Security Number <br />XXX -XX -4545 <br />Title Date <br />Revenue Supervisor <br />2 o'V'117 6.629 <br />Ng so. of 54ete Joh., to 6.1. - uct CIL <br />III! ill 1 <br />5017801895 -e Pea: <br />NARANJO GRRCIA PABLO A <br />Filed: 11/20/2017 02:42 PM <br />Spouse's Social Security Number <br />County <br />[] Corrected_ HALL <br />Taxpayer Name and Mailin • Address <br />PABLO A NARANJO GARCIA <br />826 S KIMBALL ST <br />GRAND ISLAND NE 68801 <br />1 <br />I certify that the Nebraska Department of Revenue has complied with the laws of the Stale of Nebraska In determining the amount shown to Oe due, <br />and that the taxpayer has tailed to pay the amount due after demand. This Notice of State Tax Lien is an effective Pen and serves to continue the priority of <br />the tale's interest in the attested property of the taxpayer. <br />Revenue Apent 11/16/2017 <br />(402)471 -5713 <br />Phone Number <br />11/16/2017 <br />A horized Signature Title Dale <br />4-194-1971 Raw. 8 -2013 Supentedee 4- 849-11174 Pev. 2 -R <br />