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N_EB.4 1- <br />r:. Sttry <e. <br />rew[Wn.p-nrnW <br />20190732 <br />NE Sec of State - Robert R. Evnen <br />Filing Document #: 1911001232-8 <br />Debtor Namc: LILIANA A OXLAJ JUAREZ <br />Filing Date and Time: 11/20/2019 02:50 PM <br />Pages: 1 <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 atter 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 DO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />12674982 <br />Federal ID Number <br />813977285 <br />tin Serial Number <br />11943151 <br />Lien Feed Won <br />Q Register of Deeds 0county cIe-t, <br />Social Sec4xay Number <br />XXX -XX -0570 <br />Spouse's Social Security Number <br />Dated Len <br />November 13, 2019 <br />Lien Type: <br />Q Original 0Cantswation ā¯‘corrected <br />Canty <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />LIt.UANA A OXI<AJ JUAREZ <br />111 W 9TD ST <br />GRAND ISLAND NE 68801 <br />tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Sales <br />09/01/2018 - 0950/2018 <br />10/04/2019 <br />1,125.00 <br />225.00 <br />55.51 <br />.00 <br />1.405.51 <br />Sales <br />02/01/2019 - 06/30/2019 <br />10/04/2019 <br />5,625.00 <br />1,125.00 <br />136.24 <br />100.00 <br />6,986.24 <br />Total <br />8.391.75 <br />sign <br />here <br />I caraty that the Nebraska Department of Revenue has complied matt the laws of Ire State of Nebraska in dewrrninirrq the amount shown to be due, <br />end that the taxpayer has tailed to pay the amount due alter demand. This Notice at State Tax Lien is an elective ben and seines In continue the priority of <br />the S interest in the attectay propertyoat ate taxpayer. <br />Revenue Agent <br />11/06/2019 402-471-5711 <br />/ Tale Date ?tone Number <br />{Z.1- -) Revenue Senior Agent /f- /3- / <br />130 <br />Date <br />e-444.1574 Rev. 5-2015 Supersedes 4-545-1474 he, 8403 <br />