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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 />2015 <br />06/18/2017 <br />$821.00 <br />__$41.05 <br />$44 -26 <br />j Original J Continuation <br />906.31 <br />Total <br />$906.31 <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 Hen 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 />PLEASE DO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />94079706 <br />Federal ID Number <br />Lien Serial Number <br />11601110 <br />Lien Flied With: <br />Social Security Number <br />XXX -XX -3829 <br />Spouse's Social Security Number <br />a Register of Deeds ■ County Clerk <br />Date of Lien <br />January 31, 2018 <br />Lien Type: <br />County <br />HALL <br />j Original J Continuation <br />• Corrected <br />Feb. 1. 2018 3:34PM NE Secretary of State — UCC <br />Nebraska Department of <br />REVENUE <br />Business Name and Location Address <br />Notice of State Tax Lien <br />'zed Signature Tile <br />ROLANDO TINIGUAR NAZ <br />823 W 17TH ST <br />GRAND ISLAND NE 68801 <br />201400689 <br />we <br />Us of Stele Jahn a s.10 UCC iTL <br />I <br />5915805529-7 Pas: 1 <br />TINIGUIIR NOZ ROLANDO <br />Filed: 02161 12018 03 :15 PM <br />• <br />Taxpayer Name and Mailing Address <br />I certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska in determk ing the amount shown to be Oue, <br />and !het the taxpayer has faded to pay the amount due after demand. This Notice of State Tax Lien is an effective Ken and serves to continue the priority of <br />th= fate's interest irt the a - ted property of the taxpayer. <br />Revenue Agent 01/31/2018 (402)471 -5713 <br />Illie Date Phone Number <br />Revenue Supervisor 01/31/2018 <br />Date <br />4- 4e4.1a >4 Rev, 92010 Superse0i'e 4949.1971 flak 2 -2002 <br />