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202500690 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2502000092-8 Pages: 1 <br />Debtor Name: ISRAEL J DOMINGUEZ <br />Filing Date and Time: 02/07/2025 09:37 AM <br />Good Lite. Greet Service. <br />Notice of State Tax Lien <br />This Notice of State Tax Ulm is Issued by the Nebraska <br />Department of Revenue for unpaid taxes administered by the Tax <br />Commissioner. Taxes, including penalties, interest, and coats, <br />which ere shown balore, are due from the taxpayer and remain <br />unpaid after demend.Thess 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 IIen.This lien will expire and <br />become unenforceable 10 years after the date of recording if no <br />continuation statement 1s recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />PLEASE 00 NOT WRITE INTHIS SPACE <br />Nebraska ID Number Federal ID NuOrbr <br />95913270 NO FEIN <br />Lien Serial Number <br />12695902 <br />Liam Fled With: <br />►:/ d Deeds <br />Doty Clerk <br />Social 8eelxay Number <br />XXX-XX-9600 <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />Dab d Lten <br />January 17, 2025 <br />Liern Yyp.: <br />®orpinv <br />❑continuation <br />0Corrected <br />COunnty <br />HALL <br />Business Name and Location Address <br />ISRAEL J DOMINGUEZ <br />123 N TILDEN ST <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 />2017 <br />12/18/2023 <br />$1,408.00 <br />$352.00 <br />$399.83 <br />32,159,83 <br />Individual <br />2018 <br />12/18/2023 <br />$1,532.00 <br />$153.20 <br />$357.82 <br />$2,043.02 <br />Individual <br />2019 <br />12/18/2023 <br />$1,445.00 <br />$361.25 <br />$268.21 <br />$2,074,46 <br />Individual <br />2020 <br />12/18/2023 <br />31,101.00 <br />$275.25 <br />$166.47 <br />$1,542.72 <br />Individual <br />2021 <br />12/18/2023 <br />$1,565.00 <br />$391.25 <br />$193.81 <br />$2.150,06 <br />Total <br />$9,970.09 <br />I certify that the Nebraska Deparetnent d Revenue has congaed with the bars d the Sate d Nemesia in dabmwnirp Its, amount stolen to Dodo., <br />and that IM taxpayer has fired b pay the amount due she, demand. This Notice of Stale Tax Lien Is an elieeth a Ilen and gems to nonfood' the priority of <br />to Suit's Interest In the elected property o1 the taxpayer. <br />sign g 7eiz ti i, <br />here / A4.4AL <br />Revenue Senior Assent 01/17/2025 (308)632-1210 <br />Frye Dale Phone Number <br />Revenue Supervisor 01/17/2025 <br />Authorised Signature Tian Dab <br />4-49e-1974 Rev. a•20te l,Lpeaeeirs e4e9.11074 R.4aam3 <br />