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201803631
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Last modified
12/9/2019 6:30:29 PM
Creation date
6/7/2018 3:35:47 PM
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DEEDS
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201803631
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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 />_ <br />Sales <br />01/01/2016 - 12/31/2016 <br />08/22/2017 <br />1,625.00 <br />325.00 <br />66.92 <br />.00 <br />2,016.92 <br />Total <br />2,016,92 <br />Jun. 7. 2013 3:16FM NE Secretary of State — UCC <br />o'b <br />Nebraska De0arlment 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 Hen for all property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this I 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 />Nebraska ID Number <br />1.1465824 <br />Lien Serial Number Lien Filed Wllh: <br />11807915 ® Register of Deeds County Clerk <br />Date of Lien <br />June 5, 2018 <br />sign <br />here <br />Lien Type: <br />® Original <br />Business Name and Location Address <br />Notice of State Tax Lien <br />Continuation <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Federal ID Number <br />461959420 <br />Social Security Number <br />XXX -XX -4904 <br />0 Corrected <br />RANDALL MARTTNEZ <br />1100E SOUTH ST LOT 49 <br />HASTINGS NE 68901 <br />No. 4623 F'. 2 <br />201803631 <br />NR see of I4eke Jelin 4 Get - LICE STL <br />i <br />99188 13254 -4 Pps: 1 <br />MARTINEZ RANDALL <br />Filed: 06/0712018 699 :31 AM <br />County <br />HALL <br />Spouse's Social Securely Number <br />Taxpayer Name and Mailing Address <br />1 certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska in determining the amount shown to be due, <br />and that the taxpayer has tailed to pay the amount due after demand. This Notice of State Tax Lien is an effective lien and serves to continue the priority of <br />the State's interest in me affected property or the taxpayer, <br />Revenue Agent 06/05/2018 402 -471 -6067 <br />Title Date Phone Number <br />Revenue Senior Agent b '/ zoi4 <br />Tine Date <br />4 - 494 - 1974 Rev. 8-2013 Supersedes 4-949 -1974 Rev. 2-2002 <br />
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