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NEBBAr& 4 A.. <br />20190601. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 1909001412-7 Pages: 1 <br />Debtor Name. QUEVEN E BARRIOS <br />Filing Date and Time: 09/30/2019 10:20 AM <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 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 />PLEASE 00 NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />95551751 <br />Federal ID Numae• <br />Lien Serial Number 1 Lien f Iled i Social Security Number I Spouses Social Security Number <br />11939241 ® Register of Deeds ❑ County Clerk � XXX -XX -4520 <br />Data of L en mien Type. vounty <br />September 26, 2019 j Crrg.,al DConfinuator ECorrected HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />QUEVEN E BARRIOS <br />316 E 13TH ST <br />GRAND ISLAND NE 68801 <br />Tax Program Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs i Total Due <br />Individual 2016 <br />02/02/2019 <br />5512.00 <br />525.60 <br />$45.16 <br />582.76 <br />Total i $582.76 <br />1 certify that the Nebvaska Departure 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 hos tasted en pay rho amount due alter demand. This Notice of Stage la. Lien s an erteclwe ben arid saves to contin.0 the priority of <br />the Shite, interest it Ilse ul1e1/ot1 pruporly of the taxpayer. <br />rs <br />Sign' //1 12_,-,f 1_ 1€ Number <br />' Revenue Aqent 09/26/2019 (402)471-5713 <br />here Prepay. S— rlatu e % <br />-Ile Cute Phone <br />r .........-I k- .R Revenue Supervisor 09/26/2019 <br />�AulhO,ieed Signature ' -rtie Date <br />/' 4-0)4-1974 Rev 0-nOta Supentees d•9r5.191e tie,. 5 2(r3 <br />