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NEBRAS-KA- <br />Goer! Life Great Ssce. <br />4110.6.1010a Oi =Yd.. <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2206001184-4 Pages: 1 <br />Debtor Name: ADELKIS 1ERES VEGA <br />Filing Date and Time: 06/23/2022 10:03 AM <br />Notice of State Tax Lien <br />202204606 <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 Hen 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 Hen or continuation statement. <br />PLEASE <br />NOT WRITE iS SPACE <br />NoID Number <br />89918320 <br />FodomiID Numbef <br />NO FEIN <br />Interest <br />Lion Serial N,nnb <br />12201625r01r30000 <br />Lam FOed W61 <br />DntFc6 <br />SocIal Securtty N <br />XXX -XX -1241 <br />2020 <br />1 Soctal Security Nvmber <br />NO SPOUSE SSN <br />Date of ien <br />June 17, 2022 <br />Lreerrypo.Ccunty <br />E3correated <br />HALL <br />k4 004 II Continuation <br />Business Name and Location Address <br />Taxpayer Name and Stalling <br />ADELKIS JERES VEGA <br />319 S WALNUT ST APT 209 <br />GRAND ISLAND NE 68801 <br />dress <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 />$484,00 <br />$24.20 <br />$15.75 <br />$52395 <br />Total <br />$523.85 <br />I certify that the Nebraska Department of Revenue has compiled with the laws of the Stale ol Nebraska in determining the amount shown lo be due, <br />and that the taxpayer has failed 40 pay the amount due after (*mono. Thies Notice Of State Tax Lim Is en ettectIve lien and serves to continue the pnQrtly of <br />the State's interest 10 5. affected properly ot the taeasyar. <br />sign k Revenue Senior Agent 06/17/2022 (402)471-4339 <br />here ert94er' Signe Title Daie Phone Neater <br />Revenue Supervisor 06/17/2022 <br />A4.4 ....ea, <br />Med Sig re Title Date <br />4-404-1SX nex a10111 Sweetie 4,449.1974 tte 8.20* <br />