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Good = fe. Great Se-r-ce. <br />202300/42 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2301000487-5 Pages: 1 <br />Debtor Name: MYNOR E BARAHONA MORALES <br />Filing Date and Time: 01/10/2023 10:12 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 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 OO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />14835444 <br />Federal ID Number <br />870921203 <br />Lien Serial Number <br />12314207 <br />Lien Filed With: <br />N Register of Deeds is:Coumy Clerk <br />Social Security Number <br />XXX -XX -2425 <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />Date of Lien <br />January 12. 2023 <br />Lien Type: <br />©Original DContinuation Corrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />MYNOR E BARAHONA MORALES <br />3404 W 13TH ST SUITE 162 <br />GRANT) 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 />Sales <br />09/01/2021 - 11/30/2022 <br />01/04/2023 <br />10,778.59 <br />1,575.72 <br />29906 <br />.00 <br />12,653.37 <br />Withholding <br />07/01/2021 - 09/30/2021 <br />01/04/2023 <br />10(1.56 <br />15.08 <br />3.83 <br />.00 <br />119.47 <br />Total <br />12,772.84 <br />sign <br />here Preparer's Si <br />raska Department of Revenue has complied with the laws of lee State of Nebraska In determining the amount shown to be rue. <br />faded to pay the amount due after demand. This Notice of State Tax Lien is an effective lien and serves to continue the priority of <br />fly a1 the taxpayer. <br />Autnorizr. Signature <br />Revenue Agent <br />01/06/2023 402-595-2549 <br />Title Date Phos/ Number <br />a...-17--"--2 <br />Revenue Supervisor 1/6/2023023 <br />Title Date <br />4.494-1974 Ron a-2r1e torpor os 4-949-1974 Reu. 8-2013 <br />