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Good Life. Great Se,Ice. <br />OY6Yaw11wT or lrWwVt <br />202303687 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2307000632-7 Pages: 1 <br />Debtor Name: MARLON BETANCOURT <br />Filing Date and Time 07/21/2023 10:31 AM <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 />88477002 <br />Federal ID Number <br />NO FEIN <br />Lien Serial Number <br />12339950 <br />Lien Filed With: <br />Social Security Number <br />XXX -XX -0628 <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />® Register of Deeds ■ County perk <br />Dale of Lien <br />July 19, 2023 <br />Lien Type: <br />® Original 0Cmmuation ©Corned <br />County <br />HALL <br />Busines <br />amt and Location Address <br />Taxpayer Name and Mailing Address <br />MARLON BETANCOURT <br />317SOAK 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 />2021 <br />08/19/2022 <br />51,039.00 <br />$51.95_, <br />$50.67 <br />$1,141.62 <br />Total <br />$1,141.62 <br />sign <br />here <br />I certify tat the Nebraska Department of Revenue has complied with the lawn of the State of Nebraska In determining the amount shown to be due, <br />and that the taxpayer has failed to pay Ire amount due after demand. This Notice of State Tsa Lien is an efteotve ken and serves to continue the priority of <br />Me State's interest in the affected property of the taxpayer. <br />eperer's Signature <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />07/19/2023 (402)471-0987 <br />Date Phone Number <br />07/19/2023 <br />zed Signe Title Dab <br />4-494.1974 Rev. 6-2018 Supersedes 4449.1971 Pm. 9-2013 <br />