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NEEP'rc . <br />Gotxl Life. Great Service. <br />StWITM11.1 0011.11%. <br />NE Sec of State - Robert B. Evoen <br />Filing Document #: 2202000711-9 Pages: 1 <br />Debtor Name: JACOB° PEREZ ENTERPRISES LLC <br />Filing Date and Time: 02/14/2022 10:52 AM <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 Iien.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 />13439146 <br />Federal ID Number <br />843236126 <br />Lien Serial Number <br />12206966 <br />Lien Filed with: <br />Social Security Number <br />No SS# <br />Spouse's Social Security Number <br />E7 Register 01 Deeds ❑ County perk <br />Date of Lien <br />February 3, 2022 <br />Lien Type: <br />❑Corrected <br />County <br />HALL <br />t•.! original ❑cwakvation <br />usiness Name and Location Address <br />Taxpayer Name end Mailing Address <br />JACOBO PEREZ ENTERPRISES LLC <br />TUCAN TACOS <br />2120 N WEBB RD <br />GRAND ISLAND NE 68803 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Sales <br />09.01/2020-01/31/2021 <br />03/01/2021 <br />13,310.88 <br />2,131.10 <br />621.47 <br />.00 <br />16,063.45 <br />Sales <br />02101/2021 - 02/28/2021 <br />04/01/2021 <br />4,739.24 <br />473.92 <br />124.69 <br />.00 <br />5,337.85 <br />Saks <br />03/01/2021 - 03/31/2021 <br />07/01/2021 <br />1,644.18 <br />364.42 <br />49.72 <br />.00 <br />2,058.32 <br />Sales <br />04/01/2021 - 04/30/2021 <br />07/01/2021 <br />3,945.39 <br />394.54 <br />83.98 <br />.00 <br />4,423.91 <br />Sales <br />05101/2021 - 05/31/2021 <br />07/01/2021 <br />4,079.11 <br />407.91 <br />76.44 <br />.00 <br />4,563.46 <br />Sales <br />06/01/2021 -06/30/2021 <br />08/02/2021 <br />.00 <br />393.56 <br />1.94 <br />.00 <br />395.50 <br />Sales <br />07/01/2021 -07/31/2021 <br />09/01/2021 <br />2,071.08 <br />407.11 <br />29.10 <br />.00 <br />2,507.29 <br />Sales <br />08/01/2021-08/31/2021 <br />10/01/2021 <br />3,046.45 <br />.00 <br />34.71 <br />.00 <br />3,081.16 <br />Sales <br />09:01/2021-091130/2021 <br />11/01/2021 <br />1,819.75 <br />381.98 <br />16.68 <br />.00 <br />2,218.41 <br />Sales <br />10/01/2021 - 10/31/2021 <br />12/01/2021 <br />2,687.87 <br />468.79 <br />17.23 <br />.00 <br />3,173.89 <br />Waste Reduction <br />07/01/2020 - 06/30/2021 <br />12/06/2021 <br />25.00 <br />5.00 <br />.26 <br />.00 <br />30.26 <br />Total <br />43,853.50 <br />1 certify that the Neoraska Department of Revenue has complied with the taws Of Ute State of Nebraska in determinkig the amount anown lo be due, <br />and mai the taxpayer has tailed to pay the amount due after demand. This Notice of State Tax Lien is an effective lien and serves t0 continue the priority of <br />Me State's mlerest in the affected property of the taxpayer. <br />sign, /70.44 <br />here r prepare s sgn�� <br />Aut tire <br />Revenue Agent <br />Title <br />Revenue Senior Agent <br />01/27/2022 402-471-6067 <br />Date <br />Title <br />Phone Number <br />02/09/2022 <br />Iola <br />4894.1974 nee. 0-2018 Sueuaedea 4449.1974 {ie.. &4013 <br />