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Prawn] <br />Tax Period <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Mau <br />Total Due <br />22 <br />2000 <br />0111512004 <br />617.00 <br />30.85 <br />138.70 <br />.00 <br />786.55 <br />Total <br />$786.55 <br />Jan. 2t 2414 2 :42PM NE Secretary of State — UCC <br />Nebroake <br />lisp <br />REVENUE <br />201400 <br />This Notice of State Tax Lien is issued by the Nebraska <br />Department of Revenue for unpaid taxes administered by theTex <br />commissioner. Taxes, including penalties, interest, and costs, <br />which are shown below, are due from the taxpayer and remain <br />unpaid after demand.These taxes are a Nen for all property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this Iien.This lien will expire and <br />become unenforceable 10 year after the data of recording if no <br />continuation statement is recorded en or prior to the expiration et <br />the previous Nen or continuation statement. <br />Nebraska ID Number <br />42504002 <br />Lien Serial Number <br />40650057 <br />Date of tier - <br />0310512004 <br />Business Name and Location Address <br />uc 594342 j -6 <br />Notice of State Tax Lien County kwtr.11:,z,06 <br />IJan Filed Will: <br />IN Register a Deeds ❑ county clerk <br />0 o,i,a1 © Continuation <br />PLEASE 1)0 NOT WRITE IN THIS SPACE <br />Federal ID Number <br />Social Security Number' <br />XXX- 30(4445 <br />Corrected <br />TREJOITAYRA M PEREZ <br />2018W11THAVE <br />GRAND ISLAND NE 68803 <br />NI lac of Sta4e John a Gila • UCC SCOW <br />AlI!!I <br />9914722226-4 Pao: 1 <br />F 2p -4 Filed, d Tern <br />F 14 111.39 :a9 RN <br />ile <br />Murky <br />HALL <br />Spouse's Sold Security Number <br />Taxpayer Name and Malang Address <br />t redly that the Nebra lot DeyealaneN of Revenue Ilse r:amplad with She lens of the Slate of Nebtadta In deteonting the Mount stem tabs due, <br />and Meet Om texpayet has fated to pay she amount clue alter demand. Thle Nolte cr Stale Tax Lien le an aleclNe ten and serves to continue the poorly of <br />theme's Interest In the Owed property or the taxpayer. <br />Revenue Agent Ili ip![ (402 14_71j28 <br />rep Phone Number <br />Revenue Supervisor . ,SL • 2X <br />The Date <br />4-4e1 -1974 tint 620158uawfedes 4449-1971 Flev.2,2002 <br />Ni . 2941 P. 2 <br />t5R <br />