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NEBPIP645446k of : re. tire.,..,, t. NE Sec of State - Robert B. Evnen Filing Document #: 2109001046-3 Pages: I Debtor Name. CESAR JACINTO Filing Date and Time: 09/22/2021 10:28 AM Notice of State Tax Lien 202108079 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 97384798 Federal ID Number Lien Senal Number 12180742 Lien Filed Witf: Register of Deeds [] County Clerk Social Security Number XXX -XX -1801 Spouse's Social Security Number Dale Oben September 14, 2021 Lien Type: M Original 0 Continuation ❑ Corrected County HALL Business Name and Location Address Taxpayer Name and Mailing Address CESAR JACINTO 3808 E SEEDLING MILE RD GRAND ISLAND NE 68801 Tax Program Tax Period Date of Assessment Tax Penalty Interest Costs Total Due Individual 2019 08/07/2020 _ $879.00 _ $43.95 _ $38.92 961.87 Total $961.87 sign here I certify that the Nebraska Department al Revenue has complied with the laws of the Slate of Nebraska in determining the amount shown to be due. end that the taxpayer has hailed to pay the amount due alter demand. This Notice of State Tax Lien is an effective lien and serves to continue the priority of the States interest in the affected property of the taxpayer. Revenue Agent 09/14/2021 (402)471-5833 Title Dale Phone Number Revenue Supervisor 09/14/2021 The Date 4.494-1974 rtes, 8.20,8 Supersedes 4.940.1974 f 0-20;3