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<br /> � � Notice of State Tax Lien ��
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<br /> a,w�w p�gE pp ppT WRITE IN THI4 SPACE �
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<br /> INDIVIDUAL INCGME TAX
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<br /> SOC. 3ti. ��• 385090Z4
<br /> NEBR. IDENT• NO•
<br /> . SPOUSE SGC. SEC. N0. 362781993
<br /> ��'•�- TQXABLE YEAR
<br />� LIEN NO• 9715T0068 PA'�RICK b KIMBERLY CAMPB�LL
<br /> �}�� �- C/0 RAMA HOTEL
<br />_ : - . DATETOF NOTIGE H 06/06/9T 26T R[]U7EN j E�T014
<br /> �. . DATE OF ASSESSMENY G4/G€3/Q7 �l...PTAN _
<br />�-�'��r':=_�;_.:,,;J THIS NnTIGE OF STAT� TAX LIEN IS ISSUED BY THE NEBRASKA DEPARTMENT OF
<br /> - REVENUE FOR INDIVIDUAL INtOME TAX PURSUANT TO THE BEVENUE LANS [1F THE
<br />.�� .�� '� STATE OF NEBRASKA• NOTICE IS HEREBY GIYEN 7HAT INDIVIDUAI. INCONE
<br /> Y--'����`.� ` TJ1X�S INC4UDING PENALTIES AND INTERESTt MHICH ARE SHOMN $E��M ARE DUE
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<br />�'�,'}���"� �` FROM THE TAXPAYER S P E CI FIED ABOYE AND REMAIN UNPAID AFTER D •
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<br /> - THESE TAXES CONSTITUTE A LIEN IN THE COUNTY FOR PROPERTY BELONGING �
<br /> '" .� � � THE �AXPAYER OR HEREAFTER ACQUIRED• 1y7S4.00
<br /> ��,��.Yti,�._• AM�UNT OF ?AX . . . . . . . . . . . . . . . . . .
<br /> �...:�:;,�- , PENALT1f . . . . . . . . . . . . . . . . . . . . . 446.00
<br /> , ..;.,�►Y., 4T9.56 —
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<br /> � � -- INT�REST tCOMPUI'EO TO Ob/06/9?) • � • • • • • • '
<br />- �.;m .: ' TOtAL AM�UNT DUE . • • � • • • • • • • • • • • • 2s709•58
<br /> �� �{,'. I HEREBY CERTIFY THAT THE NEBRASKA DEPAR7MENT OF REVENUE HAS COMPLIED
<br /> N�TH THE REVENUE LANS OF THE STATE OF NEBRASKA IN THE DET�RMINATICN OF
<br /> � THE AMOUNT SHOWN T� BE DUEt AND THE TA%PAYER HAS FAILED TO PAY THE
<br /> AMOUNT DUE A�TER DEMAND. IF THI5 N�TICE OF STATE TAX LIEN IS AN
<br /> � �� EXTENSION GF AN EFFECTIVE LIEN IT SERVES TO G�NTZNUE THE PRIORITY OF
<br /> � THE STATE�S INTEREST IN THE AFFECTED PROPERTY OF THE TAXPAYER. � _
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<br /> • PREPARER�S NATURE TITLE � ,�����?+_
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<br /> �'•' • • DATE
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<br /> -- - �u��un�LC�, ����...�.. •---- COUNTY—�enrod CoPY - - ,
<br /> • � TAXPAYER—Pink Copy
<br /> � NEBRASKA DEPARTMENT OF REVENUE—White and CenarY Copk� �.�4s�ri«,o-9c sw�••as�.i�s»c�«6•s,
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