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f.,V fres r.. <br />prwnrwrnt Of M'kWY <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2210000484-7 Pages: 1 <br />Debtor Name: FOXTER G PINEDA ARRIAZA <br />Filing Date and Time: 10/17/2022 09:11 AM <br />Notice of State Tax Lien <br />202207413 <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 />NWreaks ID Number <br />48640573 <br />Feaerat D Number <br />NO FEIN <br />Lien Serial Number l Lien filed With: <br />12210728 I EC Register of Deeds DCoentyCterk <br />Social Security Number <br />XXX -XX -5182 <br />Spouse's. Social Security r umber <br />NO SPOUSE SSN <br />Dale of L' i Lien Typo: <br />October 7, 2022 ® origin€ ❑ Co nu,uatioe E Corrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />FOXTER G PINEDA ARRIAZA <br />405 W 11TH <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty Interest <br />t <br />Costs <br />Total Due 1 <br />Individual <br />2018 <br />06/22/2021 <br />$306.00 <br />$76.501 $42.46 <br />$424.96; <br />Individual <br />2019 <br />07/31/2020 <br />$415.00 <br />$20.75I $31.61 <br />$467.36I <br />Total <br />$892.32 <br />sign <br />here <br />I certify that the Nebraska Department of Revenue has complied with the taws of Pat State of Nebraska in detor^Faning the amount shown to be due. <br />and that the taxpayer has tailed to pay the amount dee after demand. This Notice of State Tax Lien is an ehective ben acid serves to conenue the priority o1 <br />the State's intores1 VI the affected property of yne taxpayer. <br />P+otarer`s S€gnature <br />f uthorized Signe re <br />Revenue Agent 10/07/2022 (402)471-6043 <br />'tale Date Phone Number <br />Revenue Supervisor 10/07/2022 <br />Title Data <br />4,04-1974 Rex f 201a Sepeserfer 44949.1974 fine F-:Klt t <br />