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PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />NEF3R,AS+ <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2011000959-7 Pages: 1 <br />Debtor Name: JORGE RECANC01 SOC <br />Filing Date and Time: 11/20/2020 10:30 AM <br />Notice of State Tax Lien <br />202009119 <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 ail 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 />j <br />1 <br />Netraske ID Number <br />45889996 <br />Fedefar IC Number <br />Penalty <br />Lien Serial Number <br />12057979 <br />L.aen Filed With: <br />[J Neylster pf Deeds ❑ County Cleric <br />Social Security Number <br />XXX -XX -3689 <br />Spouse's Social Security Nun <br />r <br />Cate of Len <br />July 10, 2020 <br />Lien Type. <br />Li,(`� Or:gina: E Conti :atmn f corrected <br />County <br />HALL <br />$16,15 <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />JORGE RECANCOJ SOC <br />3619 BRONCO RD <br />GRAND ISLAND NE 68801 <br />Tax Program <br />( <br />Tax Period <br />j <br />1 <br />Date of <br />Assessment <br />Tax I <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2014 <br />06129/2018 <br />$323.00 <br />$16,15 <br />$60.65 <br />399.80 <br />Total! <br />$399.80 <br />sign <br />here <br />I codify that Pm Nebntsiut Department rI 'Revenue has (*Takeo with the laws of the State of Nebraska in Oetermimng the amount shown to be due. <br />and that trio taxpayer has tailed to pay the amount due atter demand.. This Notice of State Tax Lien t5 an effective lien and serves to continue the priority of <br />tt�q State`s interest in the affected property of the taxpayer. <br />� tit <br />Prepa•ers Sub stare <br />Authorised Signature <br />Revenue Agent <br />Tick SS <br />Revenue ..,tQ,ftiOr A <br />07/10/2020 (308)632-1208 <br />Dae Phone Number <br />07/10/2020 <br />TAle Date <br />a.a91•15)74 Orv. 6.:.115 SVIWAtMs a.pp& rant cloy 0.20 3 <br />