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201903166
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Last modified
6/3/2019 4:43:33 PM
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6/3/2019 4:43:33 PM
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201903166
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State of Nebraska 6/3/2019 3:04:24 PM PAGE 3/004 Fax Server <br />HE S€r of State Robert. B Evncn <br />Filing Document #: 1Y(.)60)0036-7 Pages: 1 <br />Itel tot Naso EFFAur OHIO LOPEZ <br />F:ling Ua, aid T nut -111 AM <br />Notice of State Tax Lien <br />201903166 <br />This Nance of State Tax Lien is issued by the Nebraska PLEASE 00 NC,T%nn-= lHTI-1 SPACE <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 rerrai:- <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 iien_This lien will expire and <br />become or forceeble 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 />t <br />r=:�deri.l C r>ambe; <br />47232757 <br />11929926 <br />May 29, 2C'19 <br />XXX -XX -294& <br />._rlarvustlon <br />i-jAIL <br />Business Name and Location Address Taxpayer Name and Mailing Address <br />CHC LOPEZ <br />NO WASHINGTON STREET <br />GRAND iSLAFI;D N1Eta <br />Tax Frogrern <br />Env pei!3d <br />Data cf <br />Assessment <br />Indic 0Lial <br />20'36 <br />3;11412616 <br />sig <br />here <br />.ax <br />gtSS5.00 <br />Penalty <br />Interest <br />52.in 971 553.5:3 <br />Costs <br />Total Due <br />Total <br />51,177 50 <br />,, . . _ 1)1014 11 21•...111 4,1 <br />`1)}t.5c Jn+�`I . t .. .. tl"• <br />1 <br />I'. <br />• <br />Revenue Agent <br />r:a<, <br />Revenue Supervi50i <br />2942019 (41.:,2471-57-12 <br />65r2S:12019 <br />
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