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Ma r, <br />21)19 2 2LAM Nr --.r-tary =f .tat- — UCC <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />:xlod Life. <br />2010014'18 <br />NE Sr, of Sate - rwbens.E' o1 <br />Piling Document #: 1903000520-4 Pages: 1 <br />Debtor Name: ELMER D PATI ARITA <br />Piling Date and Time: 01/19/2019 I I:14 AM <br />Notice of State Tax Lien <br />This Notice of State Tax Lien is issued by the Nebraska <br />Department at Revenue fur unpaid taxes administered by the Tar <br />Commissioner. Tares, Including penalties, interest, end casts, <br />which ere shown below, Are due from the taxpayer and remain <br />unpaid after damand.Theae 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 01 this Ilen.Thls lien will expire and <br />become unenforceable 10 years after the date of recording if no <br />continuation statement to recorded on or prior to the expiration of <br />the previous hen or continuation statement <br />PLEASE DO NOT WRrTE INTHIS SPACE <br />Nebraelu. ID Numbdr <br />48374997 <br />Fe4Ksl 0 Mont*, <br />lien 806•INumber <br />11925426 <br />!Jen PIM Win; <br />®Reptrler of Uredo ❑ Coonry den <br />F.mal EowrYy Numoer <br />XXX -XX -1832 <br />buouse'r Social Seo1CNy blotto, <br />0-410 w Lien <br />March 06, 2019 <br />lien Typw <br />al°mirol 0 Conainuefon ❑Cerroaed <br />County <br />HALL <br />easiness Name and Location Address <br />payer Nerne an naa nooress � <br />ELMER D PAIZ ARITA <br />708 WEST 10TH 5T <br />GRAND ISLAND NE 66801 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />- <br />Interest <br />Costs <br />Total Due <br />Individual <br />2017 <br />04310712018 <br />$267.00 <br />$13,35 <br />$8.08 <br />288.43 <br />Total <br />$298.43 <br />sign <br />here <br />I Carl� I5a' Ino Nab(o3 a DeperUnera aI tiCYen l ribs 0001040%0M Ma iav3 d Tin Jana al Noanrko In aelermining me amount e110.41 to be sue. <br />SZ 4tk !erQleyer Nshet: fi see to pay re. notunm ara Lear dmend. This NAke oI Stab Ta. Lien is en olfeetioe I:onna <br />.nd Normal° caMnn, . Itw ptlority of <br />In Ip tw Int property of Me le. gays. <br />and trot, <br />I,,,- <br />Revenue Arc ant 03/0612019 (308)632-1210 <br />H'ep6mr"F Sonmw /VIE <br />to DOM Prior} Number <br />J IE If t C. s,1 4.5-Q, ,.. 03/062019 <br />Aviivsiwo slsnewr. Tile Dem <br />4-04-! 874 Titer. e-eo+e 6.e73•neec. tie+e-t PT4 x,....: ria <br />