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Good L:fa. Greet 4erv:ce. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2202000095-8 Pages: 1 <br />Debtor Name: LEANDRO BEDOLLA MEZA <br />Filing Date and Time 02/02/2022 11:55 AM <br />Notice of State Tax Lien <br />202200888 <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 area lien for ell 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 />48307939 <br />Federal D Number <br />Lien Serial Number <br />12289890 <br />Lien Fled With: <br />® meter of Deeds ❑ county Cierfr <br />Social Security Number <br />XXX -XX -3382 <br />Spouse's Social Security Number <br />Dale of Lien <br />January 27, 2022 <br />Lien Type: <br />® original ❑ continuation <br />06/11/2021 <br />County <br />HALL <br />■ Corrected <br />us noes Name and Location Address <br />Taxpayer Name and Mailing Address <br />LEANDRO BEDOLLA MEZA <br />1216 N CLARK ST <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 />2020 <br />06/11/2021 <br />$1,426.92 <br />$77.28 <br />$30.05 <br />1,534.25 <br />Total <br />$1,534.25 <br />I certify that the Nebraska Department al Revenue has complied with the taws of the State of Nebraska in determining the amount shown n be due, <br />and that the taxpayer has faded to pay the amount due after demand. This Notice of State Tax Lien is en affective lien and serves to continue the priority of <br />the Slates interest in the affected property of the taxpayer. <br />sign <br />here <br />Preparer's Signature <br />authorized Sig re <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />01/27/2022 (402)471-0987 <br />Date Phone Number <br />01/27/2022 <br />Title <br />Date <br />4-4944974 Rev. 94010 Suparseaw 4-949.t974 Rev, 63013 <br />