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NEBRASKA <br />NE Sec of Stale - Robert R. Evnen <br />Filing Document #: 1910001141-8 Pages: 1 <br />Debtor Name: JESUS BLANCO-LOPEZ <br />Filing Date and Time: 10/18/2019 09:46 AM <br />Notice of State Tax Lien <br />201906506 <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 properly 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 />fvataas✓a ID No••nne, ? Fr-c7e <br />91657873 <br />Owl Se4a Number <br />11941139 <br />PLEASE 00 NOT WRITE IN THIS SPACE <br />Social Sar1;01y Nuntiar <br />r ct taads GrluYAy ;;lark XXX -XX -3702 <br />Delo ui Len <br />October 16, 2019 ILE�r ni <br />Business Name and Location Addres <br />Contw,uat on <br />t_ CT^ *e I HALL <br />Taxpayer Name and Mailing Address <br />JESUS BLANCO-LOPEZ <br />710 W 10TH ST <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period <br />2017 <br />Date of <br />Assessment <br />06/06/2018 <br />Tax <br />Penalty T <br />Interest ! <br />59.311 <br />Costs <br />Total Due <br />Individual <br />$973.00 <br />$4865L <br />1,080.96 <br />Total <br />51,080.96 <br />sign <br />here <br />teeny that Lho NetNxcnkn Dopa trnent (4 nu ernes: ho-, Wr�r!v,.ii <br />and that toe tar pataa has tailed to pay the amount dad ager dkma <br />ma SIIASa's interest in Pm of; affected 1000114 of 1401800age <br />N4 11... A 1_lliJttrirkl _ J' <br />1810 <br />1 <br />tale law's a the Stale of <br />dnt ,'..Rlieg Atte amooni shown 10 oo dUe. <br />t1-5 Notice of Stale Tar L100 i8 an 090(1 0 ren 8011 sa+vas Es continue Mae pootey of <br />Revenue Agent <br />9e, <br />Revenue <br />Revenue Supervisor <br />T%.kt <br />10/16/2019 (402)471-5712 <br />Dale <br />Phone Nrlmbet <br />10/16/2019 <br />[tate <br />4 au, a 0 1001 e -an 8 aftp,r t4;hfc 4 5't ^t8yd <br />