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NEB -KA <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 1912000118-1 Pages: 1 <br />Debtor Name: FRUIT -DIEGO LEON <br />Filing Date and Time: 12/04/2019 11:40 AM <br />Notice of State Tax Lien <br />201907646 <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 />fv0braska ID Number <br />12445703 <br />FedoeM 1D NurEee <br />810950306 <br />Lien Serial Nu ttttmr <br />11943043 <br />` Lien F'=.fed W4tf .. <br />Q Register of Deeds ❑ Couioy CIe.i <br />Social Enearfly Number <br />Spouses Sucipl SfaGutity Nurnbae <br />Date of Lien <br />November 13, 2019 <br />/.ten Type: <br />0e0a0 1:::::1 al ❑cnmcea <br />County <br />HALL <br />Busin <br />s Name and Location Address <br />Taxpayer Name and Mailing Address <br />FRUIT -DIEGO LEON <br />121 E 14111 ST <br />GRAND ISLAND NE 68801 <br />'fax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax 1 <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Saks <br />04/01/2017 - 04//30/2017 <br />02/01/2018 <br />.00 <br />.00 <br />15.15 <br />.00 <br />15.15 <br />Saks <br />05/01/2017 - 05/31/2017 <br />02/01/2018 <br />.00 <br />58.88 <br />12.79 <br />.00 <br />71.67 <br />Sales <br />06.01/2017 • 06/30.2017 <br />02/01/2018 <br />.00 <br />.00 <br />7.62 <br />.00 <br />7.62 <br />Saks <br />07/01/2017 - 07/31:2017 <br />03/01/2018 <br />.00 <br />183.27 <br />23.07 <br />20.00 <br />226.34 <br />Sales <br />03/01/2018-03131/2018 <br />12/03/2018 <br />.00 <br />47.33 <br />12.41 <br />.00 <br />59.74 <br />Saks <br />05/01 f2018 - 05/31/2018 <br />12/03/2018 <br />178.84 <br />103.70 <br />53.84 <br />20.00 <br />356.38 <br />Saks <br />11/01;2018 - 11/30/2018 <br />123112018 <br />186.78 <br />18.68 <br />8.27 <br />20.00 <br />233.73 <br />Saks <br />12/01/2018 - 12/31/2018 <br />07/01.2019 <br />1,485.94 <br />192.28 <br />33.05 <br />60.00 <br />1,771.27 <br />Withholding <br />10101;2017 - 12/3112017 <br />05/30/2018 <br />125.56 <br />6.28 <br />7.75 <br />.00 <br />139.59 <br />Total <br />2,881.49 <br />sign <br />here <br />of Revenue has compled eat. the taws Ott* Slide of Nebraska in <br />amount dee after demand. This Neece of State las Lien is an elective Ren and serval to cordate. the prkety of <br />y of the faaney e. <br />amount shown 10 be due.. <br />Revenue ./,gent <br />11/06/2019 402-471-5956 <br />late <br />Revenue Senior Agent <br />Gate <br />Tile <br />Phone Num <br />1 Ian, <br />Digit <br />4-0:a-1974 tem W•01$ ewes s-'978 <br />