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NJEBRASYCA- <br />. <br />Gccd L.fe. Great Sevice.. <br />NE Sec of State - Robert B. Emco <br />Filing Document #: 2303000680-8 Pages: 1 <br />Debtor Name: ALEXIS R PEREZ <br />Filing Date and Time: 03/17/2023 10:00 AM <br />Notice of State Tax Lien <br />202301279 <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 00 NOT WRITE IN TINS SPACE <br />Nebraska ID Number <br />95703225 <br />Federal ID Number <br />NO FEIN <br />Lien Serial Number <br />12323193 <br />Lien Aled With: <br />Social Security Number <br />XXX -XX -8526 <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />Register of Deeds 0County Clerk <br />Date of Lien <br />March 9, 2023 <br />1 <br />lien1,pe: <br />El Corrected <br />County <br />HALL <br />IA Original 0Comkluation <br />Business Name and Location Address <br />Taxpayer Name and <br />king Address <br />ALEXIS R PEREZ <br />915 S EDDY ST <br />GRAND ISLAND NE 68801 <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 />2015 <br />06/23/2022 <br />$1,803A9 <br />$452.50 <br />$453.98 <br />$2,709.97 <br />Individual <br />2016 <br />08/23/2022 <br />$2,288.00 <br />$572.00 <br />$505.24 <br />$3,365.24 <br />Individual <br />2017 <br />06/23/2022 <br />$2,165.00 <br />$541.25 <br />$413.13 <br />$3,119.38 <br />Individual <br />2018 <br />06/23/2022 <br />$821.00 <br />$205.25 <br />$127.31 <br />$1,153,56 <br />individual <br />2019 <br />06/23/2022 <br />$2,322.00 <br />$580.50 <br />$214.71 <br />$3,117.21 <br />Individual <br />2020 <br />06/23/2022 <br />$1,465.00 <br />$366.25 <br />$85.05 <br />$1,916.30 <br />Total <br />$15,381.66 <br />I certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska In determining the amount shown to be due, <br />and that the taxpayer has taped 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 />the State's interest In the artgcled property of the taxpayer. <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />03/09/2023 (402)471-5788 <br />Date Phone Number <br />03/09/2023 <br />Tine <br />Date <br />4494.1974 Rev. 8.2018 Supersedes 4449.1974 Rev, 8-2012 <br />