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This Notice of State Tax Lien is issued by the Nebraska <br />Revenue for unpaid taxes pursuant to the revenue laws <br />Nebraska. Notice is hereby given that taxes including penalties <br />interest, which are shown below, are due from the taxpayer <br />below and remain unpaid after demand. These taxes constitute <br />in the county for real and personal property belonging <br />or hereafter acquired. <br />Department of <br />of the state of <br />and <br />specified <br />a lien <br />to the taxpayer <br />PLEASE DO NOT WRITE IN THIS SPACE <br />- <br />Nebraska Identification Number <br />36954144 <br />Federal Idenn rfcatian Number <br />Lien Serial Number <br />32830205 <br />Lien filed With <br />E Register of Deeds • County Clerk <br />Social Security Number <br />XXX XX.6423 <br />Spouse's Social Security Number <br />Dade . - <br />10/10/2003 <br />Lien Type <br />ElOriginal ®Cordnratlon I Corrected <br />County <br />HALL <br />BUSINESS NAME AND LOCATION ADDRESS ^ <br />TAXPAYER NAME AND MAILING ADDRESS <br />PAGAN /JULIO E <br />1107W ANNA ST <br />GRAND ISLAND NE 66801 <br />Tani <br />Category <br />Number <br />Tax Period <br />Date of <br />Asa ament <br />Amount of 7as <br />Penalty <br />Interest <br />AddWons <br />Balance of <br />Aseeesaeont Due <br />2.489.55 <br />22 <br />1999 <br />08/26/2003 <br />1,857.00 <br />92.85 <br />539.70 <br />.00 <br />failed <br />move awe <br />srt i demand If <br />TOTAL <br />ki , <br />this NM4,o nr Ithata Tam 1 ion k 2n <br />$ 2,489.55 <br />I hereby amity that the Nebraska Depudme <br />amount shown to be due. and the ill9 aver has <br />Revenue : _ ., ,. <br />to eav the Ism due <br />--� . , , , <br />61111ene4,...4 ... <br />Nov. 14. 2013 1:21PM NE Secretary of State — UCC <br />. 4.1 - - <br />201309043 <br />Nebraska Department of <br />REVENUE NO <br />' www.rovenue,ne,gov ()CC <br />C i# e <br />sign PreparefaSlgnatum / Tine be • <br />here <br />_...__ ., Revenue Supervisor <br />Revenue Agent <br />Tine <br />E Elm of Simko J.M. A G.1• - UCC SEAN <br />1 11111111 <br />No. 1895 P. 3 <br />9913725901 -0 Pus: 1 <br />PAGAN JULIO E <br />Flied: 11/14/2e13 09:39 AM <br />TE TAX LIEN <br />effective Ilen, It serves to continue Yte priority tithe etude's interest in the adiereed property of the tanpayer. <br />+4111 Rsv. 2.2092 Supwaillm 4494 -I 1d Rw. 1Y� <br />(402)471 -5928 <br />Telephone Number <br />AR <br />