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N EB.F -S-KA <br />Good Life. Great Service. <br />atrwt*xtrn at w.vixxt <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2204000442-0 Pages: 1 <br />Debtor Name: LIZY EMERSON MARTINEZ <br />Filing Date and Time: 04/08/2022 09:21 AM <br />Notice of State Tax Lien <br />02202569 <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 NOTWRITE IN THIS SPACE <br />Nebraska ID Number <br />92438830 <br />Federal ID Number <br />NO FEIN <br />Lien Serial Number <br />12295998 <br />Lien Filed With: <br />Social Security Number <br />XXX -XX -0425 <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />1:4 Register of Deeds ■ Countyclerk <br />Dale of Lien <br />April 5, 2022 <br />Lien Type: <br />©Corrected <br />County <br />HALL <br />114 Original El Continuation <br />Business Name and Locati <br />Address <br />Taxpayer Name and Mailing Address <br />LIZY EMERSON MARTINEZ <br />1201 HARLAN AVE APT 62 <br />ODESSA TX 79763 <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 />2018 <br />11/26/2019 <br />$1,430.49 <br />$75.60 <br />$177.95 <br />$1,684.04 <br />Individual <br />2019 <br />08/07/2020 <br />$2,473.67 <br />$147.75 <br />$164.24 <br />$2,785.66 <br />Total <br />$4,469.70 <br />sign <br />here <br />I candy that the Nebraska Department of Revenue has complied with the laws at the State of Nebraska in determining the amount shown to be due, <br />and that the taxpayer hag tailed to pay the amount due after demand. This Notice of State Tax Lien is an effective lien and serves to continue the priority of <br />the State's interest in the affected property of the taxpayer. <br />Bri‘.3964t� <br />Revenue Agent 04/05/2022 (308)632-1210 <br />Pre_ rer's Signature Title Date Phone Number <br />�y Revenue Supervisor 04/05/2022 <br />ignatu>cil <br />Title Date <br />4494.1974 Fay. 8.2018 Supersedes 4.969-1974 Rev. 84013 <br />w <br />