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r - <br />Good Life GreatSero-ce. <br />202301126 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2303000363-4 <br />Debtor Name: YUSMILA HECHAVARRIA <br />Filing Date and Time: 03/09/2023 11:40 AM <br />Pages: 1 <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 />91868904 <br />Federal ID Number <br />NO FEIN <br />Lien Serial Number <br />12322413 <br />Lien Filed With: <br />® Register 01 Deeds 0 County Clerk <br />Social Security Number <br />XXX -XX -2728 <br />Spouses Social Security Number <br />NO SPOUSE SSN <br />Date of Len <br />March 3, 2023 <br />Len Type: <br />11/29/2021 <br />$1,023.00 <br />County <br />HALL <br />® Original ■ Continuation <br />is Corrected <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />YUSMILA HECHAVARRIA <br />10607 N 26TH STREET <br />TAMPA FL 33612 <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 />2018 <br />11/29/2021 <br />$1,023.00 <br />$51.15 <br />$157.80 <br />$1,231.95 <br />Individual <br />2019 <br />11/29/2021 <br />$707.00 <br />$35.35 <br />$64.79 <br />$807.14 <br />Total <br />$2,039.09 <br />I certify that the Nebraska Department of Revenue has complied with the laws of the Slate of Nebraska in determining the amount shown to be due, <br />and that the taxpayer has failed to pay the amount due after demand. This Notice of State Tax Lien is an effective ken and serves to continue the priority of <br />the State's interest in Urs affected property of the taxpayer. <br />sign g 7n2.4 ,,;L <br />here r , l ti46& <br />Authorized Signature <br />Revenue Agent 03/03/2023 (308)632-1210 <br />Title Date Phone Number <br />Revenue Supervisor 03/03/2023 <br />Title Date <br />4494-1974 Rev. 8-2019 Supereedes 4.949.1574 Rev. 8.2013 <br />