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Nov, 20. 2013 1:26PM NE Secretary of State — UCC -~� No. 1997 P. 3 <br />NEemsi a - ucc Ea eoa7rooa <br />05/19%2004 09:40 FAX 14024714429 <br />Entered As Instrument No <br />02004050 <br />STATE OF NEBRASKA) S` <br />COUNTY OF HALL ) <br />801 MR? 19 fin 10 55 <br />;�� ;., <br />REG OF DEEDS r <br />imorloomat <br />This Notice of State Tax Lien Is issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue taws 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. Thee taxes constitute lien <br />In the county for real and personal property belonging to <br />or hereafter acquired. <br />Nebraska IdenUOcatbrt Number <br />16993489 <br />flan Sedal Number <br />942380107 <br />r BUSINESS NAME AND LOCATION ADDRESS <br />Business Nerve <br />Street Address <br />City <br />Tax <br />Category <br />Number <br />22 <br />sign <br />here <br />Tax Period <br />1968 <br />Date of <br />Assessment <br />08/16/1994 <br />di ve <br />4 <br />2013U9184 <br />2004050 <br />Amount of Tax <br />1,177.00 <br />Name <br />Zip Code City • <br />CHILLICOTHE <br />RE <br />Lien Fled 1All6 Social Se asIV Number <br />Register of Dew D County Clerk I 504-64 -9276 <br />Date of Lien <br />07/03/1995 <br />I.s ■ra4.1..Ycc <br />; 'ill i'I <br />PL1Yd 115/111/2984 44125 P11 <br />Co 1 ing0. To, <br />-'P%19 ht4rnba.rS <br />Pea: 1 <br />NOTICE OF STATE TAX LIEN <br />Lien Type <br />D okonal Eichodato D Corrected <br />TAXPAYER NAME AND MAILING ADDRESS <br />VERNON D HAMMRICH <br />Street or Other Wang Address <br />RR3 BOX 176 <br />Penalty Interest <br />294.25 630.35 <br />State <br />MO <br />Additions <br />$ <br />I hereby wary Mal Me Nebraska Department of Revenue has oomp led Mal Me revenue laws of die Slate of Nebreake In the <br />determination of the amount shown 1n be due. and the laxpayer has tiled to Pay the amount due after demand. It Ws Nods �� <br />Tax Lien is extension of an affedive = , it serves to continue the privity of the slate's Interest In Ole affected property of <br />47 er. <br />The Agent / � � Telephone Number <br />line - �� <br />Date <br />TOTAL <br />PLEASE DO WY WRITE IN THIS SPACE <br />%d' 45 (05 3 <br />r � <br />cor/05•Zo_j__ <br />County <br />N'n <br />riper <br />64601 <br />Balance of <br />Assessment Due <br />2,301.60 <br />2,301.60 <br />