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08/16/2012 THU 14:46 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ 8a11 <br />� � <br />2012068�. ` <br />i.ti1'�Br.etk+� ��imrtrteent o�! <br />�'�'`6��E <br />'Wi«MJih�`.itfFV iFPliNib. hiti�6�Y <br />LOPEZ <br />F!led: <br />�ooa/oo3 <br />i Gale - UCC STL <br />Pes: 1 <br />ITR <br />09:13 ACI <br />NOTICE OF STATE TAX LIEN <br />This Notice of State Tax Lien is issued by the Nebraska Deparbnent of <br />Revenue fo� unpaid taxes pursuant to the �evenue laws of the state of <br />Nebraska. Notice is hereby given that taxes including 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 lien <br />in the county for real and personal p�operty belonging to the taxpayer <br />or hereafter acauired. <br />9793771 <br />1 a9 3�v QX Register of Deeds �County Clerk X)OC-XX- <br />ate o ien en ype County <br />08/17/2011 QOrigtnal �Continuation �]Corrected HALL <br />BUSINESS PIAME AND LOCATION ADDRESS TAXPAYER NAME AN� MAILING ADDRESS <br />us ness Name ame <br />LAUREANO ZURITA LOPEZ <br />ree Ad ress . Street or Ot er aiUng A ress <br />3747 DREXEL, APT 1 <br />ity e Zip Code C ty State <br />OMAHA NE <br />ax <br />Category Tax Period Date of Amount of Tax Penalty Interest Additions <br />Number Assessment As <br />01 1/112008- Q8�20/2009 375.00 75.00 47.98 <br />12/31/2008 <br />01 1 1/2009- 08/17/2010 470.00 94.00 36.63 <br />12/31 /2009 <br />68107 <br />Balance of <br />sessment C <br />497.98 <br />600.63 <br />I I I I I TOTAL I$ 1,098.61 <br />here y certify that t e ebraska Department of Revenue�ias compli wd t e revenue laws o the State of e ras a in � determ nation th� <br />amount shown to be due, and the taxpayer has failed to pay the amount due after demand. If this Notice of State Tax Lien is an extension of an <br />effecGve lien, it serv o continue t priority of the state's interest in the affected propeRy of the taxpay r. <br />e Revenue Senior Agent �L 402 471 <br />sign Pr are s at r itle Date eleph ne umber <br />here e Revenue Senior Agent 8�f /S�ZO/Z <br />utho � ig ture TiGe Date <br />q�4947974 Rer. 2-'2�02 Supersedes 4�34-1974 Rav. 10-1995 <br />Y <br />