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Q9/25/2012 TUE 16:01 FAX 402 471 4429 UCC SECRETARY OF STATS y-�� 8a11 <br />[�ooz/0o3 <br />. <br />� <br />NE Sae of Stete John N OBIe - UCC SCOIV <br />991Z699883-5 P9s: 1 <br />GARRETO JURN <br />Filed: 09/25/2072 17:64 AMI <br />ti0120&019 <br />_ N;r�aska Department of <br />����� J NOTICE OF STATE TAX LIEN <br />www.revenue.ne.gov U�� �q0321o�4-33Z <br />�-(�# aoo3o3a-19 <br />This Notice of State Tax Lien is issued by the Nebraska Department of <br />Revenue for unpatd taxes purs�rant to the revenue laws of the state of <br />Nebraska, Notice is hereby given that haxes including penalties and <br />interest, which are shown below, are due from the taupayer specifled <br />below and remain unpaid after demand. Thase taxes constitute a lien <br />in the county for reai and personal property belonging to the ta�cpayer <br />or hereafter acauired. <br />39861392 <br />30450390 <br />�Register of Dceds �County Cierkl �(X-XX-4491 <br />02/14/2003 ❑Original �Continua6on �Cor�ect� HALL <br />Bl7SINESS NAME AND LOCATION�ADDRESS TAXPAYER NAME AND INAIUNG ADDRESS <br />CARRETO/J UAN <br />424 N MAPLE <br />DANNEBROG NE 68831 <br />Category I Tax Pe�tod I Date of I Amount M Tax I Penaliy I Interest I Additio� <br />Number Assessment <br />22 � 1999 �i1/21/2002 � 1,362.08 � 68.10 <br />Balance of <br />l�sessment Due <br />r��a �s <br />TOTAL I $ 117� .75 <br />I hereby certity that the NebrasKa Department of Revenue h� rAmplied with the revenue laws of the 5tete or NeurasKa �n �e aetertmnauon or me <br />amount shown ta be due, and the tax�ayer has feiled to pay the amount due after demand. If this Nodce of State Tax Lien is an e�dension of en <br />effective lien, it servK o oontinue thE priority of the state's inter�[ in the affected property of the t�cpayer. <br />t <br />� Q/�,( �C�� Revenue SeniorAgent a, (402}471 <br />sfgn Preparers Signature Title DaCe _ Telephone Number <br />here ► Revenue Supervisor �, �J, /Z_ <br />Au rized Signatu Title Date <br />4-494-1879 Rev. 2 2602 Sup�sPAes C-494-1974 Rev. ta-1883 <br />� � <br />