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D'6 <br />W...EAASKA, <br />GGott 19e. Great Service <br />ee..1.eMu.t or•ev.rvE <br />NE Sec of State - Robert B. Damn <br />Filing Document #: 2302000302-4 Pages: 1 <br />Debtor Name ROSALBA CAVERO <br />Filing Date and Time: 02/08/2023 09:59 AM <br />Notice of State Tax Lien <br />20230062 <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 atter dernand.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 INTHIS SPACE <br />SNabrasira ID Number <br />95581883 <br />Federal ID Number <br />NO FEIN <br />Lien Serial Number <br />12319053 <br />Len Filed With: <br />® Rueter of Deeds ❑ COunty Clerk <br />Social Security Number <br />XXX -XX -7779 <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />Dole of Lien <br />February 2, 2023 <br />Len Type: <br />®Oripinel ❑continuation ❑corrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />ROSALBA CAVERO <br />1704 CURTIS 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 />2016 <br />09114/2022 <br />5.00 <br />5.00 <br />$361.25 <br />$361.25 <br />individual <br />2019 <br />08/07/2020 <br />$673,00 <br />$33.65 <br />$59.00 <br />$765.65 <br />Individual <br />2020 <br />07/14/2021 <br />$864.00 <br />$59.82 <br />$46.02 <br />$969.84 <br />Individual <br />2021 <br />05/04/2022 <br />$608.00 <br />$38.88 <br />$15.74 <br />$662.62 <br />Total <br />$2,759.36 <br />candy that the Nebraska Department of Revenue hes complied with the laws of the State of Nebraska in determining the amount shown to be due,. <br />end that me taxpayer has failed to pay the amount due after demand. Trus Notice of State Tex Men is en effective lien and serves to continue the priority of <br />the States interest in the elected properly of the tal:ayer. <br />sign 844. L d <br />here )fPmpa,rersS�l`` rte�.J) tt�J <br />Revenue Agent 02/02/2023 (308)632-2272 <br />Title Date Phone Number <br />Revenue Supervisor 02/02/2023 <br />Authorized Signature Title <br />Date <br />4-494-1974 Res. 8-2018 Suoareeoea 4449.1974 rm. 8-2013 <br />