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NEBRAS-KA <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2007000743-5 Pages: 1 <br />Debtor Name: ALFONSO PEREZ <br />Filing Dale and Time: 07/17/2020 10:29 AM <br />Notice of State Tax Lien <br />602005058 <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 />Nebraska ID Nurturer <br />47688106 <br />Date of <br />Assessment <br />Federal ID Number <br />Len Serial Number <br />12057976 <br />Leh Filed With: <br />®' -Staid D <br />âť‘Crnnrtyow* <br />Social Security Number <br />XXX -XX -2671 <br />Spouses Social Security Number <br />:Mte cA lien <br />July 10, 2020 <br />lien Type: <br />®Crlgieal <br />0 con; x+at n f C octet <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />ALFONSO PEREZ <br />APT 58 <br />3033 W CAPITAL AVENUE <br />GRAND ISLAND NE 68803 <br />Tax Program Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual 2017 <br />05/23/2018 <br />51,213.00 <br />$60.65 <br />5118.48 <br />1.392 13 <br />Total <br />51,392.13 <br />1 certify that the Nebraska Department or Revenue has complied wrrh the laws of the Stale of Nebraska. in Bete rining the amount shown to be due, <br />and that the taxpayer has railed to pay the amount due after demand. This Notice of State Tax Lien is an effective lien and serves to continue the priority of <br />Me Statex interest in the affected property 01 IPe uomayer, <br />Revenue Agent 07/10/2020 (308)632-1208 <br />Title Dave Phone Norther <br />Revenue Supervisor 07/10/2020 <br />Tale <br />Date <br />a a5a.IVA Rees, e-20-8 St;pome7041-e«-'9:4 P.68-20,1 <br />