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Tax <br />Category <br />Tax Period <br />Date of <br />Amount of Tax <br />Penalty <br />. Interest <br />Additions <br />Balance of <br />Number <br />Assessment <br />Assessment Due <br />Jan. 10, 2014 3:25PV NE Secretary of State — UCC <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. Nonce 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 Identfcation Number <br />966217D <br />Lien Serial Number <br />Dale of Lien <br />Business Nene <br />Street Address <br />City <br />01 <br />01 <br />01 <br />01 <br />10 <br />sign <br />here <br />12/23/2013 <br />BUSINESS NAME AND LOCATION ADDRESS <br />09/01 /2012 10/19/2013 <br />10/31/2012 <br />State Zip Code <br />r ep r s no re <br />20140 <br />REVENUE NOTICE OF STATE TAX LIEN <br />ww yr nua.,r.re a.. <br />Lien Feed With <br />IN Register of Deeds County Clerk <br />Lien ype <br />IA Original (Continuation <br />540.00 <br />Federal Identification Number <br />Social Security Number <br />XXX - XX - 7629 <br />County <br />HALL <br />OCorrecked <br />Name <br />ALBERTO LUNA REYNA <br />StrneI or Mar Mailing Address <br />PO BOX 581 <br />City - <br />GRAND ISLAND <br />108.00 <br />Title <br />Revenue Senior went <br />Title <br />No, 2784 P. 6/6 <br />NE sec of hair Jrhn a Isle - uee WTM <br />B9147211745-3 Fes: t <br />REYNA ALBERTO LUNA <br />Filad: /t fig44 fe! <br />PLEASE DO NOTWRITEiN THIS SPACE <br />20.02 <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue awe of the Slate of Nebraska in <br />amount shown to be due, and the taxpayer has railed to pay the emaunl due alter demand, If this Notice of Stale Tax Lien <br />offer tive lien, II as a to continue the . of the state's Interest in the effected cted property of the r. <br />Revenue Agent ° • ' °' <br />Spouse's Social Security Number <br />TAXPAYER NAME AND MAILING ADDRESS <br />State <br />NE <br />11/01/2012 <br />12/31/2012 <br />01/01/2013 <br />02/28/2013 <br />03/01 /2013 <br />04/30/2013 <br />05(0112013 <br />06/30/2013 <br />10/19/2013 <br />10/19/2013 <br />10/19/2013 <br />10/19/2013 <br />108.00 <br />540.00 <br />540.00 <br />540.00 <br />540.00 <br />108.00 <br />108.00 <br />108.00 <br />15.81 <br />12.96 <br />10.30 <br />7.59 <br />TOTAL <br />Date <br />4 -494 -1974 Rat . 2,2002 &Dereaise 4-494 -1074 Rev. 10.1906 <br />Zip Code <br />68802 <br />668.02 <br />663.81 <br />660.96 <br />658.30 <br />855.59 <br />$ 3,306.68 <br />the determine ion o <br />is en extension of an <br />402 471 -6087 <br />Teiephorye N7ber <br />1 7 <br />