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Tax Program Tax Period Date of Assessment Tax Penalty Interest Costs Total Due individual 2016 08/18/2017 $376.00 $18.80 $10.04_ 404.84 Total $404.84 This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes administered by the Tax Commissioner. Taxes, including penalties, interest, and costs, which are shown below, are due from the taxpayer and remain unpaid after demand -These taxes are a lien for all property located in the county and rights to property owned by the taxpayer or acquired before the expiration of this lien. This lien will expire and become unenforceable 10 years after the date of recording if no continuation statement is recorded on or prior to the expiration of the previous lien or continuation statement. PLEASE DO NOT WRITE IN THIS SPACE . Nebraska ID Number 92416543 Federal D Number Lien Serial Number 1180:55 Lien Filed With; Social Security Number Spouse's Social Security Number Pi Register of Deeds L 7 County Clerk Date of Lien March 06, 2018 Lien Type: ['Corrected County HALL 11 Original ■ Continuation Mar. 7. 2518 4:17F''M NE Secretary of State — UCC Nebraska Department of REVENUE sign here Business Name and Location Address I certify that the Nebraska and that the taxpayer has fa the S = imereetin 201 801.410 Notice of State Tax Lien BRAYAN D MALDONADO EUCEDA 1417 N WHEELER AVE GRAND ISLAND NE 68801 No. 3620 P. 6 µE Sec of Sidi Jphn a a .Su - vet STI. 111 11 5218807289 -9 Pes: 1 MALDONADO EUCEDA SRRYRN D Filed: 03/07/2010 02 :66 PM Taxpayer Name and Mailing Address pariment of Revenue has complied with the laws of the Slate of Nebraska in determining the amount shown to be due, to pay the amount due :r demand. This Notice of Slate Tart Lien is an effective lien and serves to continue the priority of ed properly of the Revenue Agent 03/06/2019 (402)471-6043 This Data Phone Number Revenue Supervisor 03/06/2018 Au orizedSignature Tills Date 4494 -1974 Rev. a-2ois Supersedes 4-968 -1974 Rev. 2 -2002 /�I iF