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--Ju <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 />Nebraska Identification Number <br />9688862 <br />TOTAL <br />280.00 <br />52.14 <br />BUSINESS NAME AND LOCATION ADDRESS <br />Tax Period <br />04/01/2012 <br />04/30/2012 <br />04 m m 2 <br />06/30/2012 <br />Lien Type <br />Ori ❑continuation ['Corrected <br />02/01/2014 5.00 <br />02/01 /2014 <br />Amount of Tax Penalty <br />800.00 <br />25.50 <br />Balance of <br />Assessment Due <br />1,132.14 <br />$ 1,163.02 <br />Lien Serial Number <br />I! 16 gG.3 <br />Date of Lien <br />06/22/2014 <br />Business Name Name <br />address <br />Tax <br />Number <br />sign <br />here <br />2014 11:12AM NE Secretary of State — UCC <br />Ilp4..�yk. i7roa+ V+ <br />REVENUE NOTICE OF STATE TAX LIEN <br />Lien Filed Wilh <br />201404155 <br />©Register of Deeds °County Clerk <br />Revenue Agent <br />Federal Identification Number <br />20- 3856452 <br />Social Secwriiy Number <br />XXX -XX -2333 <br />eau* <br />HALL <br />TAXPAYER NAME AND MAULING ADDRESS <br />JESUS CASTANEDA <br />SVeet or • Aing Address <br />1116 W. OKLAHOMA <br />GRAND ISLAND <br />No. 5696 P. 2 <br />ME Sim ai 4444e John R Rale - UOC 5Tl. <br />e91473Be44 —e Pgs • 1 <br />cASTntFDiR JESUS <br />Fitsd: 0812712014 01:04 lslt <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Spouse's Social Security Number <br />NE 88801 <br />I hereby certty that the Masks ' arhnent • - venue as camp with the revenue ews . e " . , ". n - in - n <br />Would ahown to be due, and the taxpayer has Failed to pay the amount due etler demand. It this Nolte of State TM Lien Is an Mansion of an <br />effective lien, it serer to continue the pripfrl of the atakte Interheat In the affected property of the taxpayer. <br />402 471-6067 <br />e p one u <br />Tale <br />Revenue Senior Agent <br />Title Date <br />4.494.1974 Rev. 2.21192 Supersedes 44941974 flew, 15-1996 <br />f <br />