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(91 <br />NEB A <br />i .rr r;rer- ',ere'ce. <br />OI <br />202207453 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2210000662-3 Pages: 1 <br />Debtor Name: YUNISLEYDI PADILLA LOPEZ <br />Filing Date and Time: 10/18/2022 11:18 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 alt 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 IS SPACE <br />Nebrasiw ID Number <br />48429430 <br />Federal ID Number <br />NO FEIN <br />Lien Serial Number <br />12211164 <br />Lien Had With: <br />23 Pegistor or Deeds ❑ County Clerk <br />Social Security Number <br />XXX -XX -2174 <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />Date in Lien <br />October 13, 2022 <br />• <br />Lien Type: <br />® Original ❑ Continuation 0 Corrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />YUNISLEYDI PADILLA LOPEZ <br />7230 MANGROVE DR LOT 4 <br />NORTH CHARLESTON SC 29418 <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 />08/31/2021 <br />$982.00 <br />$92.78 <br />$50.82 <br />$1,125.60 <br />Total <br />$1,125.60 <br />1 certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska in determining the amount shown to be due. <br />and that the taxpayer has failed to pay me amount due after demand. This Notice of State Tax Lien is an attendee lien and serves to continue the priority of <br />the Slates interest in the affected property til die taxpayer <br />sign �2�;� <br />here r'reparer'a ignature <br />f46,A/f146,0— <br />Authorized <br />utt,orized Signature <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />10/13/2022 1308)632-1210 <br />Date Phone Number <br />10/13/2022 <br />Title Date <br />4.494.1974 nom 8.2018 Supersedes 4.1148.1974 nes. 8.20,3 <br />