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202303413
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7/6/2023 3:54:11 PM
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7/6/2023 3:54:11 PM
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202303413
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Gout Lite. Great Service. <br />eestnHrxr er a11vrnve <br />202303413 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2307000140-1 <br />Debtor Name: JOSE SAUCEDA <br />Filing Date and Time: 07/06/2023 11:41 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 ell property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this Iien.This filen 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 />Nebraska ID Number <br />93112378 <br />Fedamt ID Number <br />NO FEIN <br />Lien Serial Number <br />12337416 <br />t.ian Fled Wiifi: <br />Social Security Number <br />XXX -XX -0220 <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />i7Registerot Deeps ❑Cota,ryaerx <br />D9te of lien <br />June 26, 2023 <br />Lien Type: <br />❑Corrected <br />County <br />HALL <br />El origkial El Continuation <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />JOSE SAUCEDA <br />3403 TRI ST APT C <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 />2020 <br />11/24/2021 <br />$488.00 <br />$50.21 <br />$45.13 <br />$583.34 <br />Individual <br />2021 <br />06/17/2022 <br />$983.00 <br />$14.73 <br />$44.84 <br />$1,042.57 <br />Total <br />$1,625.91 <br />I certify that the Nebraska Department of Revenue has compked with the laws of the Stale 01 Nebraska in determining the amount shown to be due, <br />and that Me taxpayer has felled to pay the arnouni due atter demand. This Notice of State Tax Lien is an effective ben and serves to continue the priority of <br />the Steto's interest in the affected property of the taxpayer. <br />sign ` �'?uaa�� <br />here Preparer's Signature Q Tine <br />Log.adi Revenue Supervisor <br />Revenue Agent <br />Authorized Signature <br />06/26/2023 (308)632-1208 <br />Date /tune Number <br />06/26/2023 <br />Title Date <br />4-494.1974 Nev, 8.2010 Supersedes 4449.1074 lies. 9.201E <br />
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