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Tax - <br />Category <br />Tax Period <br />Date of <br />Amount of Tax <br />Penalty <br />Interest <br />Additions <br />Earanee of <br />Number <br />Assessment <br />_ <br />Assessment Due <br />,Jan, 2014 3:2EPM NE Secretary of State — UCC <br />oa <br />Lien Serial Number <br />Date of Lien <br />Business Name <br />Street A <br />City <br />22 <br />e `"'r•n'on -r <br />less <br />37593382 <br />40440187 <br />07/28/2004 <br />2000 <br />12/18/2003 <br />Lien Filed With <br />201403296 <br />atr'�*',ke U .tmir,c7M <br />REVENUE <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 />or hereafter acquired. <br />111Register of Deeds ❑County Clerk <br />Lion Type <br />0Oripinal ®Contlnuailon <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Zip Code <br />1,023.00 <br />ID Dia Ricks `,. !.T , r revenue Agent <br />sign P :.'rs �,. <br />here 0 ,� ► , � j�f Revenue Supervisor <br />=burs Title <br />rile <br />Federal Identification Number <br />Name <br />City <br />Social Security Number <br />XXX-XX-6721 <br />OCorrected <br />Nathan t_ Pease <br />Street or Other Mailing Address <br />2104 W Division Apt 3 <br />Grand Island <br />TOTAL <br />of the <br />51.15 <br />County <br />Hall <br />228.44 <br />in the affected property of the taxpayer. <br />05/29/2014 <br />Date <br />No. 5061 P. 2 <br />me S., oT stmt. John p pate UCC 9eU0/ <br />11111 <br />9914730ee -1 Pes: 3 <br />PEACE NATHAN L <br />Filed; 03/03/2014 11410 An <br />NOTICE OF STATE TAX LIEN <br />PLEASE DO NOT WRITE IN THIS SPACE <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />Spouse's Social Security Number <br />Slate <br />NE <br />Zip Code <br />68803 <br />1,300.59 <br />$ 1,300.59 <br />I hereby cerey Mat the Nebraska Department o Revenue has compiled to the revenue laws of the State of Nebraska in the determination <br />amount shown to be due. and the taxpayer has failed to pay the amount due alter demand. If this Notice of State Tax Lien is an autt•n ■ion Of an <br />effective lien, it serves to continue the priority <br />Date <br />4-494-1974 Rev. 24002 Supereadas 4.494 -1974 R0410 4eae <br />SEe ATTACHMENTS <br />308 632 -1206 <br />telephone Number <br />05/29/2014 <br />