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NE Sec of State - Robert B. Evnen Filing Document 4: 2105000793-1 Pages: 1 Debtor Name: MARILUZ Y PADILLA ESPINOZA Filing Date and Time 05/18/2021 10:09 AM Notice of State Tax Lien 202104159 This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes administered by the Tax Commissioner. Taxes, including penalties, interest, and costs, which are shown below, are due from the taxpayer and remain unpaid after demand. These taxes are a lien for all property located in the county and rights to property owned by the taxpayer or acquired before the expiration of this lien. This lien will expire and become unenforceable 10 years after the date of recording if no continuation statement is recorded on or prior to the expiration of the previous lien or continuation statement. PLEASE DO NOT WRITE IN THIS SPACE Nebraska ID Number 92028977 Federal ID Number Lien Serial Number Lien Filed With' 12173604 ® Register of Deeds County Clerk Social Security Number XXX -XX -3619 Date of Lien 1 Lien Type: May 12, 2021 ®c rgnal (]Continualion 0 Corrected Spouse's Social Security Number 1 County IHALL Business Name and Location Address Taxpayer Name and Mailing Address MARILUZ Y PADILLA ESPINOZA 1414 SAINT PAUL RD 58 GRAND ISLAND NE 68801 Tax Program Tax Period Date of Tax Penalty Assessment Interest Costs Total Due Individual 2016 12/04/2018 $725.061 $36.60 $118.82 880.48 Total $880.48 1 tardy drat die Nebraska Department of Revenue has complied with the laws o1 the Stale o1 Nebrasite in determining the amount shown 10 tie due. and mal Pet taxpayer has faded to pay the amount due alder demand. 'his Notice at State Ira lien is an effective lien and serves to continue the priority of the State's interest at the affected property Of the taxpaye, sign heresSgnaf" y,,Ltnarized Signature Revenue Agent 05/12/2021 (402}471-0987 Title Revenue Supervisor Dade ?00,10 Number 05/12/2021 Tek, Date 4-4,e-1974 r..— 4-2018 Supe ee000 4-949.1974 Rev. a•po2