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07/12/2012 THU 14:07 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ �all <br />`''i <br />�� <br />201205722 <br />�004/005 <br />_ �� „,., <br />, , �,. � � -;: ' <br />�i�rasM+. a�. e�a+lrruwnc a� <br />���� <br />www.r+r�'varwas�. r,�.sro+. <br />NOTICE OF STATE TAX LIEN <br />This Notice of State Ta�c Lien is issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant tc the revenue laws ot the state cf <br />Nebraska. Notice is herehy given that taxes including penalties and <br />interest, which are shown below, are due from the taxpayer specfied <br />below and remain unpa(d after demand. These taxes constitute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter acpuired. <br />9688862 <br />� � / � QX Register of Deeds QCounty <br />Lien Type <br />07/08/2012 []X Original `]Continuation <br />BUSINESS NAME AND LOCATION ADDRESS <br />Category � Tax Pe�lod � Date of <br />01 ."," „`""" 03/08I2010 <br />11/30/2009 <br />01 01 /01/2010 py25/2010 <br />01/31/2010 <br />01 02/01 /2010 05/06/2010 <br />03/31t2010 <br />0 ,� 04/01/2010 07/06/2010 <br />05/31/2010 <br />01 ��01/2010 11l02/2010 <br />06/30/2010 <br />Amount of Tax <br />493.00 <br />744.02 <br />244.74 <br />700.45 <br />84.49 <br />20-3856452 <br />XXX-XX-2333 <br />�Corrected Hall <br />TAXPAYER NAME AND MAll.ING ADDRE55 <br />Jesus Castaneda <br />t or Other Mafling Address <br />1196 W. Oklahoma <br />Grand Island <br />Penalty Interest <br />Ne. <br />Additlo�t.s <br />25.00 85.8A <br />0.00 88.06 <br />50.00 27,53 <br />72.11 73.39 <br />25.00 8.26 <br />TOTAL <br />68801 <br />Balance of <br />603.84 <br />832.08 <br />322.27 <br />845.95 <br />117.75 <br />$ 2,721.89 <br />l heceby cQC[ny thac tne Nenrasxa uepaRment ot Revenue nas compfiea wttn tne revenue iaws or Tne s[a[e or rveorasxa m me ae�erm►nauon or �ne ` <br />amount shown to be due, and the taxpayer has failed to pay the amaunt due after demand. if this Notioe of State T� Llen is an extension of an <br />effective lien, it serve ntinue the priority e state's interest in the affected property of the taxpayer. ! <br />� <br />402 471-6067 ' <br />e � Revenue Agent /� a / � <br />sign repa rs Signature Title Date Telephone Number <br />here e Senior Revenue Agent <br />uthorizBal Signature TiUe Date " <br />4�-094-1974 Rev. 2-2002 Supefsed0s 4-494-1874 Rev.10-1995 <br />f <br />1 ' <br />' I <br />