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202306387
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12/7/2023 3:19:38 PM
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12/7/2023 3:19:38 PM
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202306387
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Good Lde. Great Service, <br />oe.+.+.w. 00.11.1.111 <br />202506387 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2312000234-1 Pages: 1 <br />Debtor Name: JOSE 0 RIVAS RAMOS <br />Filing Date and Time: 12/07/2023 11:12 AM <br />Notice of State Tax Lien <br />This Notice of State Tax Uen 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 THIS SPACE <br />Nebraska ID Number <br />48458813 <br />Federal I) Number <br />NO FEIN <br />Lion Serial Number <br />12354534 <br />Lien Filed With: <br />52 asgiater of Deeds []County Cleric <br />Social Security Number <br />XXX -XX -0058 <br />Spouses Social Security Number <br />XXX -XX -2395 <br />Date of Lien <br />December 4, 2023 <br />Lien Type: <br />® °m.; ā¯‘Continuation ElCorected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />JOSE 0 RIVAS RAMOS <br />CARLA C RIVAS <br />307 LITTLE BLUESTEM DR <br />GRAND ISLAND NE 68803 <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 />2019 <br />11/29/2022 <br />$143.00 <br />$50.25 <br />$108.29 <br />$301.54 <br />Individual <br />2020 <br />11/29/2022 <br />$2,942.00 <br />$147.10 <br />$279.61 <br />$3,368.71 <br />Total <br />$3,670.25 <br />sign <br />here <br />I certify that the Nebraska Department of Revenue hes complied with ate laws of the State of Nebraska in determining the amount shown to be due. <br />and that the taxpayer has failed to pay the amount due atter demand. This Notice of State Tax lien is en effective tion and serves to continue the priority of <br />the State's interest in the affected property of the taxpayer. <br />- :wrfl4t <br />./JA044: <br />Authorized signature <br />Revenue Senior Anent 12/04/2023 (3081632-1203 <br />Title Date Phone Number <br />Revenue Supervisor 12/04/2023 <br />Title Data <br />4-494.1974 Rev. 62010 aupearne,a 4946/974 Rev. 9.2013 <br />
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