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202500629 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2502000091-9 Pages: 1 <br />Debtor Name: BELKIN GONZALEZ <br />Filing Date and Time: 02/07/2025 09:36 AM <br />NEBRrA.77' A -- <br />Good Lde. Great 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 costa, <br />which am 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 B 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 INT1eS SPACE <br />Nebraska ID Number Federal D Number <br />98493205 NO FEIN <br />Uen Serial Ntm b* <br />12596803 <br />Lion Riad WIN: <br />►:i Register orDeeds <br />©Cantycleft <br />Social Seaeay Number <br />XXX•XX•6204 <br />Spaces Social Securer NNrntwr <br />NO SPOUSE SSN <br />Nis of win <br />January 31, 2025 <br />lienTrue: <br />❑ ConenuatIcn <br />❑C0 mC1ed <br />Garay <br />HALL <br />0:4 apkrl <br />Business Name and I. on Addrase <br />BELKIN GONZALEZ <br />1408E 5TH PO BOX 543 <br />GRAND ISLAND NE 68802 <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 />2016 <br />01/0812024 <br />$2,458.00 <br />$614.50 <br />$776.46 <br />$3,848.96 <br />individual <br />2017 <br />01108/2024 <br />$1,306.00 <br />$326,50 <br />$373.37 <br />$2,005.87 <br />Individual <br />2018 <br />01/0812024 <br />$1,340.00 <br />$335.00 <br />$335.18 <br />$2,010.18 <br />Individual <br />2019 <br />01/08/2024 <br />$534.00 <br />$133.50 <br />$100.14 <br />$767.64 <br />Individual <br />2021 <br />01/08/2024 <br />$3,740.00 <br />$935.00 <br />$470.31 <br />$5,145.31 <br />Total <br />$13,777.96 <br />I certify Nat the Nebraska Department al Rasmus has compiled welt the haws of the Stale of Nebraskan delernnIn q the amount shown b be due, <br />and Mat the taxpayer has Wed to pay the amount due afar demand Thls Notice of BIM Tax Lien be an elective len and serves b continue Me prirmy cr <br />the 8We's Merest In the seeded properly or the impure,. <br />sign k Revenue Senior Agent 01/31/2025 (4021471-4339 <br />here TM" <br />_� Revenue Supervisor Date Phone Number <br />01/31/2025 <br />Tam Date <br />41114-1*74 Ran e-2a1e StpaMrs 44441974 Pma. s-91l <br />