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Tax <br />Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2008 <br />11/25/2013 <br />430.00 <br />107.90 <br />99.42 <br />636.92 <br />• <br />Total <br />$bS6.92 <br />C <br />U !, <br />N4bra.l� O.pa'tm.nt or <br />REVENUE <br />This Notice of State Tax Lien is issued by the Nebraska <br />Peparfinent of Revenue for unpaid taxes administered by the Tax <br />Commissioner. Taxes, including penalties, interest, and costs, <br />which are shown below, are due from the taxpayer and remain <br />unpaid after demend.These taxes area Men for all property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this lien. This lien will expire and <br />become unenforceable 10 years after the date of recording it no <br />oontinuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />Nebraska 10 Number <br />37563068 <br />Uen Sera Num er <br />11436422 <br />Dare of Lien <br />0710712014 <br />sign <br />here <br />2014 2:42PM NE Secretary of State — UCC <br />Lien Fled Writ <br />Ragi'er of Wade ❑ Courtly Clark <br />tlen'lyee: <br />[Vonowd <br />0 Cmr1Ir ti n <br />Z+A L ._,f ! ! - 4 /, <br />� f <br />_at _ II <br />Signature <br />201404159 <br />Notice of State Tax Lien <br />KLEASS b4 ROT WRITE IN THIS SPACE <br />Federal ID Neuter <br />Soda! SOcurity NenOar <br />XXX- XX-4922 <br />❑Carreotea <br />CODY T WHITE <br />208 N FIRST STREET <br />• <br />Revenue Agent <br />roe <br />Revenue Supervisor <br />The <br />No.5708 P. 2 <br />of 51.+. ' who A e.l. - e:c S7 <br />99147.8863 -1 Psis: <br />!MITE CODY T <br />F11=4; 07/09/2014 01:21 Pas <br />Spousal! Seal Security Number <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mall ng Addr <br />nn.uwu... ur •nn <br />i Deady Vat the Netted's Oepeasen of Revenue hao complied with De laws of the Glare of Nebraska in deteminig the amount shown to De dye, <br />lino bat the taxpayer has failed to pay t he amount due alter demand. This Wipe of Slats Tee Lien is an effective lien and Berm ID =Owe the pdoitty of <br />me Stales inrerest In the a = tad properly of tie taxpayer. <br />Dale <br />(402)4716789 <br />Phone Mow <br />Dale <br />4.404104 Acv, 0-2013 JS(N04a 4948 Rev.IIOQ2 <br />