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CiQ of tire, Great Serv,ce, <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2304000841-6 <br />Debtor Name: MIGUEL A BRING REYES <br />Filing Date and Time 04/19/2023 09:44 AM <br />Pages: 1 <br />Notice of State Tax Lien <br />202 301 891 <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 />47767308 <br />Federal 0 Number <br />NO FEIN <br />I. Serial Number <br />12327271 <br />Lien rood With: <br />® Register of Deeda ❑ County Clerk <br />Social Security Number <br />XXX -XX -2727 <br />Spouse'a Social Security Number <br />NO SPOUSE SSN <br />Date of Lion <br />April 12, 2023 <br />Lien Type: <br />❑corrected <br />County <br />HALL <br />P4 Original ❑continuation <br />Business Name end Location Address <br />Taxpayer Name and Mailing Address <br />MIGUEL A BRING REYES <br />1079 W 38TH ST <br />HIALEAH FL 33012 <br />Tax Program <br />I Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2020 <br />08/30/2022 <br />$489.00 <br />$122.25_ <br />$30.67 <br />$641.92 <br />Total <br />$641.92 <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 tailed to pay the amount duo after demand. This Notice of State Tee Lien is an effective Fen and serves to continue the pthxity of <br />the State's interest in she affected properly of the taxpayer. <br />sign' S #6 <br />here Prep/errt�(n_ s�igtat,um/ t <br />.L_.Fzi /Y9p'g2, <br />Authorized Signature <br />Revenue Agent 04/12/2023 (308)632-1208 <br />Title Date Phone Number <br />Revenue Supervisor 04/12/2023 <br />Title Date <br />4-494-1974 Rev. 8-20:0 3Wmaodes 4.549.1974 Flee. 5•2013 <br />