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OB/29/2012 6�1'ED 14:19 FAX 402 471 4429 UCC SSCRETARY OF STATE -�yy Hall 2012�`72�2 � �� �ooz/ooa � . N�akaD.eparCmentof I�EVEN�E � TE TAX LIEN www.revenue.ne.gov �J(_C� Q,325`��- — Ci'�#- � 3 This Notice of State Ta�c Llen is issued by the Nebraska Departrnent of Revenue for unpaid taxes pursuant to the revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are shovm below, are due from the taxpayer specified below and remain unpaid after demand. These taxas constitute a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. 41329252 11800043 �Register aF Deeiis �Courdy Clerkl XXX-XX-4898 02I12I2003 QOriginal �Contiinuaatiion �Corre�ed HALL BUSINESS NAME pND LOCATION ADDRES9 TAXPAYER NAME MID MAIUNG ADDRESS OLIVAREZ/DELIA S 209 EAST 7TH STREET GRAND ISLAND NE 68801 � Category � Tax Period � �ate of 22 I 1998 Amount of Tex Penalty 331.00 16.55 Inter�t � Additio►�s 112.28 TOTAL $ Balance of 459.83 459.83 amaunt shawn to be due, and the ta�ay� has f�led to pay the amount due aRer demar�d. If this Notice of SYate Tax U� is an e�e�sion of an effective lien, it serv to con6n� tF� prioriry aF the state's interest in the affected prope�ty of the taxpayer. ► 1 Revenue Agent � d,�- �� (402�171-5928 sign �s ' Tifle te Td�h N here ► Revenue Supenrisor 2 �- Authar¢ed Signawre Title �� 4�94-1974 Rev.2-20Q2 Saµetsadea 4�494-1974 Rev.14-1985 ;�� � �. ..:.. �� :', i.��'� i• ; �:. i: ;