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07/17/2012 TUE 13:55 FAX 402 471 4429 UCC 5SCR13TARY OF STATE �-�� Ha7.1 <br />201�0��4� <br />J <br />, , <br />@�0o3�ooa <br />_ uc� srt, <br />Pes: 4 <br />7 ANi <br />- ��'�...--'_'e�.�-- <br />Nebraska ��partmant of <br />�E'���� NOTfCE OF STATE TAX L1EN <br />www.revenue.ne.gov <br />This Notice of State Tax Lien Is issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. No�ice is hereby given that taxes inciuding penalt�es and <br />tnterest, which are shown below� are due from the faxpayer specified <br />below and remain unpaid after demand. These taxes cons�ltute a l[en <br />in the county for real and personal property belonging to the taxpayer <br />983$9769 <br />11288989 ]Re�.st� of Deeds [�Caur�ty Cledc XXX-XX-2065 <br />Dete of Ven U� Type County <br />07/16/2012 �Original []Cw�tinuation [�Corrected HALL � <br />BUSINESS [�NYlE IWD LOCATION MDRESS TAXPAYER NAeAE AND MA141NG A�DRESS <br />MANUEL E LOPEZ BATEN <br />309 W 6TH ST <br />GRAND ISLAND NE 68801-4510 <br />Category Tax Pedod Date of <br />Number Assessment . <br />22 20Q8 01/01/2�10 <br />Amourtt of Tax Penalty ' <br />186.00 9.30 <br />Interest I Addttlons <br />58.46 <br />TOTAL I $ <br />ealance of <br />253.76 <br />253.76 <br />amount shavm to 6e dus, anc! fha taxpeyer F� �Fa(led in pay ihe art�unt due after derr�nd if this No6oe of State Tax Lien ls an e�deasion of an <br />effedive Ifen, it serves to aontinue the pdority of ttee state's Interest in the affect� ProPe►1Y of fhe �cpayer. <br />� - (402}471-5713 <br />sign rep r's ig e Date el�tron Number <br />here ► ' ,� � Revenue Supenrisor ( yr- <br />Authodzed Sfgn ce Title Date <br />44941814 Rev. Y�2002 Supersed� 4�484-1874 Rev 1898 <br />