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10/17/2012 WED 15:07 FAx 402 471 4429 UCC SECRETARY OF STATE -��y Hall <br />� <br />� <br />1 <br />�o�.�d�6�Q <br />1►�ebraske 4T�riP�►3rtea►�st a� <br />������� <br />wwMt.s �► V Yp�+ra. n i.i'iav <br />This Notice of State Tax L9en is issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice is hereby given that taxes including penaltfes and <br />interest, which are shown below, are due from the taxpayer specified <br />_ below and remaln unpaid after demand. These taxes constitute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter ac4uired. <br />10335102 <br />Category <br />Number <br />01 <br />01 <br />21 <br />21 <br />21 <br />27-3730609 <br />o a QRegister of Deeds �Counly Clerk XXX-XX- <br />Lien Type Couoty <br />10/12/2012 QOriginal [�Continuation �Corrected Hall <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILIPIG ADDRESS <br />Tax Perlod I Date of <br />' "„' ., "" ' " 06/06/2011 <br />12/31/2010 <br />07/01/2011 08/13/2012 <br />03/31/2012 <br />01/01 /2011 02/05/2012 <br />09/30/2011 <br />10/01 /2011 08/13/2012 <br />12/31/2011 <br />01/01/2012 08/13/2U12 <br />03/31/2012 <br />Amount of Tax <br />82.76 <br />965.00 <br />285.00 <br />95.00 <br />25.00 <br />�002/004 <br />1,215.34 <br />405.63 <br />132.82 <br />53.07 <br />68801 <br />Balance of <br />Assessment Due <br />143.71 <br />NOTICE OF STATE TAX LIEN <br />Santos S. Abarca <br />t or Othe� Mailing Address <br />380 N. Cedar St. <br />Grand Isiand <br />Penalty Interest <br />0.00 60.95 <br />210.50 39.84 <br />103.50 17.13 <br />34.50 3.32 <br />27.50 0.57 <br />Ne. <br />Additfons <br />TOTAL <br />amount shown to be <br />effedive lien, it se <br />� <br />sign Prep i <br />here e /�, <br />$ 1,950.57 <br />sKa uepartment ot rtevenue has compuea witn tne revenue iews or me �w�e or neorasKa �n u�r aC►Crrmn�uvn v< <n� <br />the taxpayer has ' d to p�y the amount due after demand. IF this Notice of State Tax Lien is an extension of an <br />nue the priori e state'sVnterest in the affected property of the taxpayer. <br />0 402 471-6067 <br />Reven ue Agent /� /�s ~ � �� �--- <br />iture Title Date Telephone Number <br />Senior Revenue Agent /(?� 1 S= / Z <br />ature Title Date <br />4�194-7974 Rer. 2-2002 Supersedes 4�94•7874 Rev. 10•1885 <br />\��I <br />i <br />