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og <br />1 EBRA&KA <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2305000080-2 Pages: I <br />Debtor Name: ASHLEY RIOJAS <br />Filing Date and Time: 05/02/2023 08:56 AM <br />Notice of State Tax Lien <br />202302155 <br />This Notice of State Tax Lien Is issued by the Nebraska ?PLEASE DO NOT WRITE IN THIS SPACE <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 1 <br />unpaid after demand.These taxes are a lien for aU 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 />Nets+asks til Number <br />13416499 <br />Federal ID N <br />842618536 <br />Lien Serial Number <br />12316138 <br />Lien Piled 1Mth.. <br />®4 Reoissnr of Deeds [3 qty Chem/ <br />Liar Type:..... <br />® Or, eial 0 Conarwation <br />Social Secunry Number <br />XXX -XX -9768 <br />CCanected <br />SPOtatea Social Sedlrlly No m Or <br />NO SPOUSE SSN <br />County <br />H &U. <br />Date Or Lien <br />April 10, 2023 <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />ASHLEY RTOJAS <br />LOLITAS PALETERIA <br />305 KOENIG ST <br />GRAND ISLAND NE (r8801 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />"Tax <br />Penalty <br />Interest <br />Costs <br />Ibtal Due <br />Litter Fee <br />0701 `2019 - 06/302020 <br />11/20'2021 <br />.00 <br />25.00 <br />.00 <br />.00 <br />25.00 <br />Sales <br />09:01.2019 - 12/342019 <br />05/01/2020 <br />.00 <br />100.21 <br />10.47 <br />.00 <br />110.68 <br />Saks <br />01`01/2020-07'3l2020 <br />11%14'2020 <br />1.155.00 <br />240.50 <br />120.82 <br />.00 <br />1,566.32 <br />Sales <br />08/0112020 - 08:31 /2020 <br />11;20;2021 <br />205.00 <br />45.50 <br />17,98 <br />.00 <br />268.48 <br />Sales <br />09f01/2020 - 09/302020 <br />111202021 <br />205.00 <br />45.50 <br />17.14 <br />.00 <br />267.64 <br />Saks <br />1001:2020 - 1031.2020 <br />11.20.2021 <br />205.00 <br />45.50 <br />16.27 <br />.00 <br />266.77 <br />Sales <br />11101;2020 - 11,30'2020 <br />1 I (2012021 <br />205.00 <br />45.50 <br />15.42 <br />.00 <br />265.92 <br />Sales <br />12.01.2020 - 12:31 2020 <br />I 1020 2021 <br />205.00 <br />35.50 <br />14.78 <br />.00 <br />265 28 <br />Total <br />3,036.09 <br />certify that the Nebraska Department of Revenue has complied with the laws of die State of Nebraska in determining /tut amourit shover to ss due. <br />and that the taxpayer has failed to pay the amount due after demand. This Notice of Slate Tax Len is an e0ective lies and prows to continue tire priority of <br />Inc States interest in the erected properly 01 the taxpayer. <br />Sign �_i _ _ L H� - <br />............. <br />here Peepaf8r'i SgnatUfF <br />Aut <br />Signature <br />Revenue Anent <br />Tills <br />Revenue Supervisor <br />04/03/2023 402-430-6554 <br />Dare Phone Number <br />Tine <br />4/3/2023 <br />Date <br />S.PL�- i $?J ii.iS ii-iitits ihipee n,lii R.54b.is J4 Rev 5.45r:f <br />