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