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Good Life. Greet Service. <br />au+eun„r a scwwc <br />202208438 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2212000240-3 Pages: 1 <br />Debtor Name: TIMOTHY PADRON <br />Filing Date and Time: 12/07/2022 10:14 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 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 THIS SPACE <br />Nebraska ID Number <br />96480394 <br />Federal ID Number <br />NO FEIN <br />Lien Serial Number <br />12215660 <br />Lien Filed With: <br />® Register ofDeeds 0 County Clerk <br />Social Security Number <br />XXX -XX -6253 <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />Date Or Lion <br />December 1, 2022 <br />Lien Type: <br />0corrected <br />County <br />HALL <br />11 final ■ Continuation <br />usiness Name and Location Address <br />Taxpayer Name and Mailing Address <br />TIMOTHY PADRON <br />502 W 16Th ST <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 />Individual <br />2019 <br />10/01/2021 <br />$501.33 <br />$363.50 <br />$103.64 <br />$968.47 <br />Individual <br />2020 <br />06/11/2021 <br />$1,047.00 <br />$54.85 <br />$49.96 <br />$1,151.81 <br />Total <br />$2,120.28 <br />sign <br />here <br />1 caddy that the Nebraska Department of "avenue has complied with the laws of the State of Nebraska In deter/lining the amount shown to be due, <br />and that the taxpayer Cres tailed to pay the amount due after demand. This Notice of State Tax Lien Is art eaectve lien and serves to coMHue the priority el <br />the State's Interest In the aaected properly of the taxpayer. <br />Preparer'e Signature <br />Revenue Agent 12/01/2022 (402)471-6043 <br />Title Date Phone Number <br />Revenue Supervisor 12/01/2022 <br />horized Signe re Tdle <br />Dam <br />4.484-1974 Pere -2018 Superseders 44494574 Reit 9.2013 <br />