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Tax <br />, 4 <br />Category <br />Tax Period <br />Date of <br />Amount of Tax <br />Penalty <br />n <br />Additions <br />Balance of <br />Number <br />Assessment <br />- �' : <br />Assessment Due <br />03/19/2013 TUE 15:01 FAX 402 471 4429 UCC SECRETARY OF STATE <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 />9662170 <br />Lien Serial Number <br />Date of Lien <br />Business Name <br />Street Address <br />City <br />01 <br />01 <br />01 . <br />01 <br />01 <br />02/21/2013 <br />Lien Filed With <br />Lien Type <br />BUSINESS NAME AND LOCATION ADDRESS <br />01/31/2010 04/06/2010 <br />r` a lars�kw OIPpsrlrraer,t o! <br />REVENUE NOTICE OF STATE TAX LIEN <br />+wwvtrt•.vrvs•n.se.rsr..pfev <br />Register of Deeds UCounty Clerk <br />State Zip Code <br />0.00 <br />-. -0y <br />Federal Identification ts <br />Original ['Continuation Corrected <br />0.00 <br />201302166 <br />Social 4ecurity Number <br />44,4 -7629 <br />Name ,' a ` <br />ALBERTO LUNA RFYNA <br />Street or Other Mailing Ar <br />PO BOX 501 <br />City , <br />GRA IS LAND <br />03/01/2010 <br />04/30/2010 <br />06/01/2010 <br />08/31/2010 <br />09/01/2010 <br />11/30/2010 <br />01/01/2011 <br />04/30/2011 <br />07/06/2010 <br />10/05/2010 <br />02/07/2011 <br />07/06/2011 <br />0.00 0.00 <br />0.00 0.00 64 <br />0.00 0.00 <br />0.00 <br />32.1,7 <br />Q <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the $ta tg`of Nebraska in the determination of the <br />amount shown to be due, and the taxpayer has failed to pay the amount due after demand. If this N of State Tax Lien is an extension of an <br />priority 1 <br />p y ' state's interest in the affected property of Ole ta1ggyec <br />effective lien, it ser)r <br />continue the <br />sign Pre• <br />here 8 /, <br />'Revenue Agent 4 <br />Hall . 0004/004 <br />Hall <br />NE Sec of State John A Gal o - UCC ST <br />1 11 11 1 1111 11 1111 11 <br />9913711033 -3 Pes 1 <br />LUNA REYNA ALBERTO <br />Filed: 03/19/2013 11:3B AM <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Spouse's Social Security Number <br />TAXPAYER NAME AND MAILING ADDRESS <br />State <br />NE <br />Title <br />Senior Revenue Agent <br />Title <br />+4 f4 Rev.2 -2002 Supersedes 4. 494.1974 Rev. 10 -1995 <br />Zip Code <br />1.80 <br />16.88 <br />9.64 <br />8.32 <br />48.66 <br />$ 85.30 <br />402 471 -6067 <br />Telephone Number <br />3 - I3�-13 <br />Date 1\ <br />