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NF B A&f4A.. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2005000913-4 Pages: 1 <br />Debtor Name: GABRIEL ESCALONA LAGO <br />Filing Date and Time: 05/27/2020 10:47 AM <br />Notice of State Tax Lien <br />zo20O34 4 <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 DO NOT WRITE IN THIS SPACE <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />Nobras'ka ID Number <br />95620567 <br />Peder'at C Nu er <br />Lien .Serial laane;r ; lien filed Wotr: <br />12055109 Re mte'ctQoods QCoun:yclerk <br />Sac:al Se.^,urity l400Wer <br />XXX -XX -7654 <br />Spousen 5os:a': Seconly dumber <br />0.te ci t.ior iiia ^:`� e; <br />May 22, 2020 EXf cr0tnai ricanttnuatan, Dcoot'esat <br />Canty <br />HALL <br />usiness Name and Location Address <br />Taxpayer Name and Mailing Address <br />GABRIEL ESCALONA LAGO <br />1103 W6 ST <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period <br />Date of 1 <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Assessment I <br />Individual <br />2017 <br />11/23/2019 I <br />$777.00 <br />538 851 <br />$70-67 <br />886.52 <br />Individual <br />2018 <br />11/23/2019 <br />$652.00 <br />$32.60; <br />$35.99 <br />720.59 <br />Total <br />$1,607.11 <br />I Lertily tool tee Neixasea Detrdrlr_"aent at 'vane has cone:1:eud n W ISO €a'N0 of the Stale of l <br />t Lha #a3tbai r Tom$ toiled ;< caro t ,_. an eontdu�. atter ee,and, This Notice Cl slat€ too Len <br />ttw Stole's a:: <br />sign <br />here r preparersSynuwre <br />AsI0onzea Signal <br />Revenue <br />Tc1e <br />Revenue Supervisor <br />e <br />ne <br />nt shown la be due.. <br />tenI rc o lI e poex$y 01 <br />05/22/2020 (30)632-1203 <br />Phone NsWber <br />05/22/2020 <br />w <br />Daly <br />4-43k4,. *-14 R(0 5-25ta Svaemeaea 4-500-iszn 040 $403 <br />