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NE See of State - Robert B. Eynon 202405301 <br />Filing Document #: 2410000520-6 Pages: 1 <br />Debtor Name: JOSE L JIMENEZ <br />Filing Date and Time: 10/25/2024 09:57 AM <br />Uae <br />Good Lila Greet Service. <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, ere due from the taxpayer and remain <br />unpaid after demand.Theee 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 Fen.Thle pen 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 INT IS SPACE <br />NabnxMa ID Honorer Federal q Nu.faar <br />88014177 NO FEIN <br />Lam <br />12463434 <br />lien fated N511e <br />® Seceder Deeds <br />['County a.rlc <br />Soatu s.curMy Nwnber <br />XXX,XX 2713 <br />SpouseSada' Seoub N <br />NO SPOUSE SSN <br />Date of Lien <br />October 4, 2024 <br />Lien lip.; <br />❑Con.ani <br />County <br />HALL <br />Business Name and Location Address <br />JOSE L JIMENEZ <br />909 J ST <br />COZAD NE 69130 <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 />2022 <br />05/05/2023 <br />$616.00 <br />$30.80 <br />$45.40_ <br />$692.20 <br />Total <br />$692.20 <br />sign <br />here <br />I tiny that the Natrona Denanm.ro of Romeo has compl ad with the I.w. el I. Stele of Nebr.ate b d.Wnii3O the .moos shown b be dub <br />end that the taxpayer hoe fated to peythe amount des idler dernmd.lies No of Stale Tan Llit Y an issed,• Om and soma b eonaaa the plorry of <br />the SiaMs Interest In to d.ct.d popery of the lump. <br />Arlxodmd SfPrtun <br />RevenueAcfnt 10/04/2024 (3081632-1206 <br />rids Dili Phan. Number <br />Revenue Supervisor 10/04/2024 <br />rids ow <br />4-404.11174 Nut 8101110upero las 44111•10is w.l 4Ura <br />