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201209883
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Last modified
11/28/2012 8:11:48 AM
Creation date
11/27/2012 4:49:00 PM
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DEEDS
Inst Number
201209883
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Tax _....._ <br />Category <br />Number <br />Tax Period <br />.1/1 /)nno_ <br />Date of <br />Assessment <br />Amount of Tax <br />..,., <br />Penalty <br />.,.� <br />Interest <br />,.a- <br />Additions <br />VWWVO <br />Balance of <br />Assessment Due <br />11/27/2012 TUE 8:33 FAX 402 471 4429 UCC SECRETARY OF STATE <br />(1) <br />This Notice of State Tax Lien 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 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 property belonging to the taxpayer <br />or hereafter acquired. <br />Nebraska Identification Number <br />9893652 <br />Lien Serial Number <br />Date of Lien <br />Business Name <br />Street Address <br />City <br />01 <br />01 <br />11,2 70,2 . 8 <br />10/26/2012 <br />BUSINESS NAME AND LOCATION ADDRESS <br />12/31/2009 <br />1/1/2010- <br />12/31 /2010 <br />1/1/2011- <br />12/31 /2011 <br />08/17/2010 <br />Lien tided With <br />State <br />201 209883 <br />Nwh.a,ekso Oe.anart...pr.t od <br />REVENUE <br />WWM. •e.Yt�.Y - O 0 .I <br />Register of Deeds OCounty Clerk <br />Lien Type <br />Original DContinuation Corrected <br />Zip Code <br />1,710.00 <br />Title <br />Name <br />342.00 <br />a -11-0 <br />Federal Dumber <br />Social Security Number <br />xxx -xx -1417 <br />County <br />HALL <br />Street or Other Mailing Address <br />217 E 12TH <br />City <br />Hall <br />08/07/2012 3,825.00 765.00 146.71 <br />NE Sec of State John R Gale - <br />991270343 —5 <br />TRACY PATRICE L <br />Filed: 11/2 /2012 10:46 AM <br />NOTICE OF STATE TAX LIEN <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Spouse's Social Security Number <br />TAXPAYER NAME AND MAILING ADDRESS <br />PATRICE L TRACY <br />235.42 <br />612.00 238.27 <br />TOTAL <br />situ I l bt i P Revenue Senior Agent !0)I?)ZO)Z <br />sign P •are =cure Title Date <br />here ® "Ill 4 /i/j4 t 1 /ii Revenue Senior Agent <br />thor - • Sig - ur <br />State <br />4-494 -1974 Rev. 2 -2002 Supersedes 4.494 -1974 Rev: 10-1995 <br />/2002/002 <br />ucc <br />PGs 1 <br />Zip Code <br />2,287.42 <br />3,910.27 <br />4,736.71 <br />10,934.40 <br />ereby certi that the Ne•ras a e partment of Revenue has comp led with t e revenue aws o the State o ebraska in t e etermination of t e <br />amount shown to be due, and the taxpayer has failed to pay the amount due after demand. I this Notice of State Tax Lien is an extension of an <br />effective lien, it se - s to co tinue the priority of the state's interest in the affected properly of the taxpayer. <br />sn <br />402 471 -5709 <br />Telephqne Nu ber <br />/I POkaacR <br />Date <br />
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