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07/19/2012 THU 15:04 FAX 402 471 4429 UCC SECRETARY OF STATE -�-�-+ Hall <br />♦ <br />�� <br />20120593G <br />OROZCO <br />Filed: <br />�004�00� <br />2 08:69 AM <br />�ir►hrac#�: �a�srtneant+oa <br />�E�I�E NOTICE OF STATE TAX LIEN <br />+wwvv,..�•v..wa..r...t. �o.. <br />This Notice of State Tax Lien ts issued by the Nebraska Department of <br />Revenue for unpaid taxes pur.suant to the revenue laws of the state of <br />Ne6raska. Notice is he�eby given that taxes inciuding penalties and <br />interest, which are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These taxes constitute a 11en <br />in the county for real and personal properly belonging to the taxpayer <br />or hereafter acquired. <br />8887144 <br />[�X Register of Deeds �County Clerk XXX-XX-9472 <br />Lien 7ype County <br />07/18/2012 QOriginal []Continuabon [ICorrected Hall <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />me Name <br />RAFAEL OROZCO <br />ss Street or Other Mailing Address <br />2105 N. NASHVILLE � <br />e �p code c�ty sc�te <br />Category Tax Period Date of <br />Number Assessment <br />01 06/01 /2010 02/07/2011 <br />11/30/2010 <br />01 12J01 /2010 08/04/2011 <br />01/31/2011 <br />2 � 01/01/2010 08/10/2011 <br />03/31/2010 <br />2 � 04/01/2010 02/11/2011 <br />09/30/2010 <br />2 � 10/01/2010 Q8/10/2011 <br />12/31/2010 <br />amount shown to be <br />effective lien, it serv <br />sign e repai <br />here 8 � <br />and the taxpayer <br />'�ntinue the prior <br />Amount of Tax <br />2,186.73 <br />899.82 <br />0.00 <br />0.00 <br />0.00 <br />GRAND ISLAND NE. 68803 <br />Pena(ty Interest Addldons Balance of <br />267.56 <br />43.15 <br />0.00 <br />7.66 <br />47.20 <br />221.49 <br />64_73 <br />12.57 <br />y <br />25.59 <br />12.87 <br />TOTAL <br />Assessment Due <br />2,675.78 <br />1,007.70 <br />12.57 <br />33.25 <br />60.07 <br />$ 3,789.37 <br />venue nas compllea wun tne revenue laws of the 5tate of Nebraska in the determinaGon of the <br />d to pay the amount due after demand. lf this Notice of State Tax Lien is an extension of an <br />state's interest in the affeGed property of the taxpayer. � � <br />� Revenue Agent 7<.2 0 �� 402 471-6067 ; <br />Title Date Telephone Number ': <br />'�� Senior Revenue Agent 7_� — � L � <br />Tltle Date <br />4-484-1974 Rev.2-2002 Supersetles4-494-1974 Rev.10-7885 <br />� <br />