State of Nebraska 8/28/2019 3:40:31 PM PAGE
<br />NEOW,c;KA--
<br />5/008 Fnie§tg 224
<br />NE See of State - Robert ES Evnen
<br />Filing Document 14: 1 9 0 80 0 1 4 58 - 0 Pages: 1
<br />Debtor Name LAURA GUARDIOLA
<br />Filing Date and Time OS/28/2019 11 46 AM
<br />PLEASE FE TLIRN TO:
<br />NEBRAS.KA oro REVENUE
<br />PO F:OX 94609
<br />LiNCOLN 6g509 -4I309
<br />Notice of State Tax Lien
<br />This Notice of State Tax Lien is issued by the Nebraska
<br />Department of Revenue for unpaid taxes ad -ministered 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 demanci.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 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 />.1048q837
<br />t.kg, Nt:roWle
<br />11936260
<br />August 22, 2019
<br />PLEASE 00 NOT WAITE IN -MS SPACE
<br />Xi
<br />Business Name coo Locanon address
<br />Tax Program
<br />fax Pc-tioti
<br />HALL
<br />Taxpayer Name end Usitino Address
<br />LAURA GUARr.i6A.A
<br />220 CARDiNAL DR
<br />GRAND ISLAND NE 68803
<br />Dale of
<br />Assessment
<br />0 110:8120 I 7
<br />Tax
<br />Pflf5;3i;'y
<br />$.179.78
<br />Interiasl
<br />523 59
<br />$83.24
<br />Costs i Total Due
<br />567.01
<br />lcal $r87.01
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<br />sign, Revenue: Agent 08122;2019 (8061632-12E33
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<br />Revenue Supervisor 081'2212019
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