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201302816
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4/8/2013 3:47:48 PM
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4/8/2013 3:47:48 PM
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DEEDS
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201302816
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ur nerearter acquirea. <br />Nebraska Identification Number <br />24353477 <br />Federal Identification Number <br />Lien Serial Number <br />11325505 <br />Lien Filed With <br />3 Register of Deeds 1 County Clerk <br />Social Security Number <br />XXX -XX -4677 <br />Spouse's Social Security Number <br />Date of Lien <br />04/04/2013 <br />Lien Type <br />7 Original II Continuation II Corrected <br />County <br />HALL <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />- <br />TIMOTHY G DAUGHTERTY <br />924 W 7TH ST <br />GRAND ISLAND NE 68801 <br />Tax <br />Category <br />Number <br />Tax Period <br />Date of <br />Assessment <br />Amount of Tax <br />Penalty <br />Interest <br />Additions <br />Balance of <br />Assessment Due <br />22 <br />2008 <br />03/25/2011 <br />667.00 <br />193.69 <br />129.05 <br />989.74 <br />TOTAL <br />$ 989.74 <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State oUNehraska in the determinetinn of th <br />04/08/2013 MON 15:24 FAX 402 471 4429 UCC SECRETARY OF STATE - -. Hall 0002 /002 <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 />• <br />20130281E <br />Nebraska Department of <br />REVENUE NOTICE OF STATE TAX LIEN <br />www.revenue.ne.gov <br />amount shown to be due, and the taxpayer has failed to pay the amount due after demand. If this Notice of State Tax Lien is an extension of an <br />effective lien, it serves to continue r t in the affected property of the taxpayer. <br />sign <br />here ► <br />Revenue Agent <br />itle <br />Revenue Supervisor <br />Title <br />PLEASE DO NOT WRITE IN THIS SPACE <br />NE <br />1 <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />See of State John 5 Gale - UCC <br />9913712454 -6 Pas 1 <br />DAUGHTERTY T MOTHY G <br />Filed: 04/08 2013 12:08 PM <br />4494 4974 Rev. 2.2002 Supersedes 4494 -1974 Rev. 10-1995 <br />STI <br />
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