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Good UN. Great Service. <br />2024011 95 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2403000683-4 Pages: 1 <br />Debtor Name: DIALEXIS LEIVA GOMEZ <br />Filing Date and Time: 03/22/2024 10:03 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 area 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 Tula SPACE <br />N.waaw 10 Number <br />92507557 <br />Federal 10 Number <br />NO FEIN <br />Lien Serial Number <br />12463919 <br />Iden FNW Wille <br />avow at Dawe 0 county cle* <br />Social Security Number <br />XXX -XX -5623 <br />Spouse's Social Security akonbar <br />NO SPOUSE SSN <br />Dae or Men <br />March 13, 2024 <br />usn rypa: <br />(X) *tam 0 Contimallon [lam <br />County <br />HALL <br />Business Nam* and Location Address <br />axpayer Name and IllaliIng <br />DIALEXIS LEIVA GOMEZ <br />203 E 9TH 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 />2020 <br />06/11/2021 <br />$1,872.00 <br />$93.60 <br />$203.56 <br />$2,169.16 <br />Total <br />$2,169.16 <br />leerily that the Nebraska Department of Revenue has compiled with the laws of the Sista d Nebraska In detnminkig the amount shown to be dee. <br />and that the taxpayer hes Wed to pay the amount due after demand, This Notice of State Tax Uan h an arta* an and savesto continua the priority of <br />the Stews interest in the affected property of the lakPaeor, <br />sign k Revenue Agent 03/13/2024 (3081tz32-1206 <br />here r Preparefs Straftge Tse Date Phone Number <br />jidtdi A1044 Revenue Supervisor 03/13/2024 <br />Authorized Signature Tab Oats <br />4.401.11/74Mv. 54016 Supersede. 4440.1117.1 tier. 84013 <br />