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NEB , S44A- <br />tlf�xx�i W*QYM <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2005000884-3 Pages: 1 <br />Debtor Name: JOSE M CARRAZCO GALLARDO <br />Filing Date and Time: 05/27/2020 09:45 AM <br />Notice of State Tax Lien <br />202003410 <br />This Notice of State Tax Lien is issued by the Ne.braska <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 tabes 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 />Nebraska ID Nu obe, <br />39730476 <br />Federal IC Number <br />Lien Senal Number <br />12054934 <br />Cate of Lent <br />May 19, 2020 C <br />Business Name and Location Address <br />Lien rain WHIG.. <br />riegi=.ter tat € Beds ❑ County Clerk <br />Lien type: <br />7i Oa rginal <br />Social Se. urity N <br />XXX -XX -B <br />Number <br />Continuation <br />Spt:cse's Social Ses..r'ny Number <br />444 XXX -XX -9282 <br />County <br />^.t6rl HALL <br />Taxpayer Name and Mailing Address <br />❑Cede. <br />JOSE M CARRAZCO GALLARDO <br />BLANCA E SANCHEZ GRANADOS <br />1708 LARIAT LANE <br />GRAND ISLAND NE 68803 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />interest <br />Costs <br />Total Due <br />Individual <br />2017 <br />06/05/2019 <br />$428.00 <br />$107.00 <br />$38.75 <br />573.75 <br />Total <br />$573.75 <br />I certify that the Nehreste'+Department of Revenue has compbed with the jaws of the State of Nebraska in aetermkur the amour', shown to be are, <br />and that tree taxpayer has': aep to pay 14-amount due after demand. This Notice of State Tax Lea is an etlecci a lien and serves to continue the priority at <br />the State's ftiViesti: t Ne clot Wrry rat !tin taxpayer. <br />Revenue <br />rine / <br />Revenue Supervisor <br />Ttk <br />05/19/2020 (308)632-1203 <br />Date Phone Number <br />05/19/2020 <br />Date <br />4.434-t OTO Rev. e.2»Se Srpe"xeues a-9'3-'eTa R,. a-201 a <br />