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felEB .& n. <br />20210705 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2108000950-1 Pages: 1 <br />Debtor Name: GOMEZ DETASSELING CONTRACTOR LLC <br />Filing Date and Time: 08/17/2021 12:03 PM <br />Notice of State Tax Lien <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.Thls 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 />Nebraska ID Number <br />13375555 <br />Federal ID Number <br />834318059 <br />Len Serial Number <br />12103564 <br />Lan Filed With <br />Q Resister of Deeds Ej County Clerk <br />Social Security Number <br />Spouses Social Security Number <br />Date of Lien <br />August 5, 2021 <br />Lien Type: <br />NIOriginal0Continuation fvlCorrects° <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />GOMEZ DETASSELING CONTRACTOR LLC <br />313 N DARR AVE <br />GRAND ISLAND NE. 68803 <br />Tax Program <br />Tax Pcrwd <br />Date of <br />Assessment <br />Tax <br />Penalty ! Interest <br />Costs <br />Total Due <br />Withholding <br />04.-01/2019-12/31/2019 <br />07/102020 <br />300.00 <br />105.001 22.83 <br />.00 <br />427.83 <br />Total <br />427.83 <br />I certify that the Nebraska Department of Revenue has complied with the taws of the State of Nebraska in Determining the amount shown to be due. <br />and that the taxpayer has failed to pay the amount due after demand.This Notice of State Tao Lien is an effective lien and serves fo continue the priority of <br />the Stales interest in the affected property of the taxpayer. <br />sign <br />aa4, G h.24 �eLUG <br />here r Preparers 3 tura <br />Authorized Signature <br />Revenue Agent <br />08/11/2021 402-471-5717 <br />Title <br />Revenue Senior Agent <br />Date <br />Phone Number <br />8-12-21 <br />Title Date <br />4.194.1974 Rev 0.201e Sup.nsws a -949.197a nr.. 8-20'3 <br />