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Good Lire. Gr ;Servcu-. es.*.+.:xraecevexun NE Sec of State - Robert B. Evnen Filing Document #: 2301000089-7 Pages: 1 Debtor Name: SERGIO DOMINGUEZ MACIAS Filing Date and Time: 01/05/2023 09:43 AM Notice of State Tax Lien 202300055 Tnts Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes administered by the Tax Commissioner. Taxes, including penalties, interest, and costs, which are shown below, are due from the taxpayer and remain unpaid after demand.These taxes are a lien for all property located In the county and rights to property owned by the taxpayer or acquired before the expiration of this lien, This lien will expire and become unenforceable 10 years after the date of recording if no continuation statement is recorded on or prior to the expiration of the previous lien or continuation statement Nebraska PLEASE DO NOT WRITE INTNIS SPACE ID Number 48515663 Llan Federal 0 Number NO FEIN Serial Number 12216474 Date Lien Lien FIOd Wkh: ® Register of Deeds ❑County ctarlr Somal Security Number XXX-XX•0566 — Spouses Social Security Number NO SPOUSE SSN of December 30, 2022 uen Type.. ❑ Corrected County NALL i 4 original ❑ Continuation $555.00 $43.85 axpayer Name and Mailing Address SERGIO DOMINGUEZ MACIAS 904 W 8TH ST GRAND ISLAND NE 68801 sign here 1 certify that the Nebraska Department of Revenue has compiled YAM the laws of the State of Nebraska In determining the amount shown to be due. and Meat the taxpayer has failed to pay the amount due after demand. This Notice of State Tax Lien Is an epactive lien and serves to continue the priority of the Stank interest In the affected propetry of the taxpayer. Revenue Agent 12/30/2022 (402)471-5833 Title Date Phase Number Revenue Supervisor 12/30/2022 This Data 4.494.1974 en, 52018 Supersedes 44454974 R4v.8.25t3 Tax Program Tax Period Date of Assessment Tax Penalty Interest Costs Total Due Individual 2019 11/06/2020 $555.00 $43.85 $46.10 $644.95 Total $644.95 sign here 1 certify that the Nebraska Department of Revenue has compiled YAM the laws of the State of Nebraska In determining the amount shown to be due. and Meat the taxpayer has failed to pay the amount due after demand. This Notice of State Tax Lien Is an epactive lien and serves to continue the priority of the Stank interest In the affected propetry of the taxpayer. Revenue Agent 12/30/2022 (402)471-5833 Title Date Phase Number Revenue Supervisor 12/30/2022 This Data 4.494.1974 en, 52018 Supersedes 44454974 R4v.8.25t3