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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 />2016 <br />06/06/2017 <br />$435.00 <br />$41.75 <br />$14.44 <br />491.19 <br />Total <br />$491.19 <br />1 <br />May.29, 2013 12FM NE Sa„retary State — UCC <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <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 lien.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 lien or continuation statement. <br />Nebraaka ID Number <br />92489443 <br />Lien Serial Number 'Lien Flied with: <br />11807330 ® Register of Deeds County Clerk <br />Dale of Lien Lien Type: <br />May 24, 2018 ® original <br />sign <br />here <br />Business Name and Location Address <br />/u,thorize. Sign ur <br />Notice of State Tax Lien <br />Federal ID Number <br />Social Security Number <br />XXX -XX -2712 <br />Continuation D Corrected <br />111 Soc of Pate <br />- 1.H„ R Gel.. • UCC ■TL <br />4918812522 -2 Pas 1 <br />MILAN BRUGUERR JORGE M <br />Wed; 0512912019 10 :59 1 <br />PLEASE DO NOT WRITE IN THIS SPACE <br />county, <br />HALL <br />Taxpayer Name and Mailing Address <br />JORGE M MILAN BRUGUERA <br />23538 MAPLE VIEW DR <br />SPRING TX 77373 <br />artment of Revenue has complied with the laws of the State of Nebraska In determining the amount shown to be due, <br />to pay the amount clue attar demand, This Notice or State Taw Lien Is an effective lien and serves to continue the priority of <br />operty of the taxpayer. <br />Revenue Agent 05/24/2018 <br />Nc.4 '36 F. 2i <br />201803384 <br />Spouses Social Security Number <br />(308)632-1210 <br />Phone Number <br />05/24/2018 <br />Title Date <br />Revenue Supervisor <br />Tula Date <br />4.194.1974 Rea. 8 -2012 Supersedes 4 - 949 - 1974 liar. 2-2002 <br />