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Good Lite. Groot Service. <br />202401 51 1 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2404000372-0 Pages: 1 <br />Debtor Name: VINCENT MENDEZ <br />Filing Date and Time: 04/09/2024 10:36 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 />Nebrasla. Kt Number <br />13408496 <br />Federal iD Number <br />827268132 <br />Lien Serial Number <br />12422989 <br />Lien Fed WISE <br />® ReWeIer of Deeds 0 Cavy perk <br />Social Security Number <br />XXX -XX -5058 <br />Spouse's Social See", Ntmshe <br />NO SPOUSE SSN <br />Oats of Lien <br />Marto 21. 2024 <br />Lion Typo: <br />0 Corraded <br />County <br />HALL <br />E! OfillinIV 0 COnlIntgiflon <br />Business Name and Location Address <br />axpsyer Nsnte an <br />VINCENT MENDEZ <br />MENDEZ ENTERPRISES LLC <br />2404 WEST LINCOLN HWY <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 />Waste Reduction <br />07/01/2020 - 06/30/2021 <br />12/06/2021 <br />25.00 <br />5.00 <br />2.47 <br />.00 <br />32.47 <br />Withholding <br />01/01/2021 -03/31/2021 <br />11/10/2021 <br />2,575.82 <br />643.96 <br />286.51 <br />.00 <br />3,506.29 <br />Withholding <br />04/01/2021 -06/3012021 <br />11/10/2021 <br />2,512.02 <br />251.20 <br />260.41 <br />.00 <br />3,023.63 <br />Withholding <br />07/0112021- 09/30/2021 <br />11/10/2021 <br />1,752.62 <br />87.63 <br />168.42 <br />.00 <br />2,008.67 <br />Withholding <br />10/01/2021 - 12/31/2021 <br />03/25/2022 <br />1,051.92 <br />52.60 <br />88.80 <br />.00 <br />1,193.32 <br />Withholding <br />01/01/2022 - 03/31/2022 <br />09/17/2022 <br />116.67 <br />.00 <br />15.80 <br />.00 <br />132.47 <br />Withholding <br />04/01/2022-06/30/2022 <br />02/10/2023 <br />_ 147.95 <br />.00 <br />10.93 <br />.00 <br />158.88 <br />Total <br />10,055.73 <br />I certify that the Nebraska Department Cl Revenue has complied with the taws of the State of Nebraska In determining the amount shown to be due, <br />and that the taxpayer has tailed to pay the amount due alter demand. Tisk Natoe of Stat. Tax Lien at an aeeetive Den and serves to continue the priority of <br />the State's interest in the affected properly Cl the taxpayer. <br />signyi4a 714zotor. <br />here ' Prep.rre, <br />Authorised ignature <br />Revenue Senior Ag4ent <br />Tide <br />Revenue Supervisor <br />03/14/2024 402-471-6067 <br />Date <br />Tale <br />Phone Number <br />4/5/2024 <br />tate <br />4+97-1974 mora -7010 Su.er.Wa 4.04.1774 Wr.4013 <br />