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Ito <br />Program <br />Tax Period <br />Detect <br />Aaeoaar. srt <br />Tax <br />Penalty <br />Interest <br />costs <br />Toth Due <br />Individual <br />• <br />2010 <br />07/23/2013 <br />494.00 <br />62.70 <br />147.03 <br />703.73 <br />_ <br />TAW <br />9703.73 <br />Sep. 4, 2014'• 2:29PM' NE Secretary of State — UCC•• No. 6496 <br />Nsh,w��k dparanrm <br />REVENUE <br />This Notice of State Tat Lien is Issued by ihs Nebraska <br />Department of Fteverare for unpaid taxes administered by Mello( <br />Commissioner. Taxes, Inducing penalties, interest, and costs, <br />which are shown below, are due from the taxpayer and remain <br />unpaid after demand.Thene taxes are s Ilen for all property located <br />in the moiety and rights to property owned by the taxpayer or <br />acquired before the expiration of this Iien.This Hen will expire and <br />become unenforceable 10 years after the date of recording 11 no <br />continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />Nebraela ID Number <br />99857197 <br />Lien Sena Number I kJr Rled With <br />11438984 ® AagderOrDMA Dourly Clerk <br />Dale or Uen Line TIAN <br />0812Bt2014 ® o"dnai ❑ combination <br />Business Name and Location Address <br />201405523 <br />Notice of State Tax Lien <br />Federal ID Number <br />Sadol Sesuity Number <br />XXX- 17(.5226 <br />D on <br />HENRY A CALLEJAS <br />810 W 14TH ST <br />GRAND ISLAND NE 68801 <br />I aerlry Use the Nebrwka Department al Hew ribs tempted will the laic of the Stare of Nebraska in delermk*g rye amount shown b ba due. <br />end the Iaxpeyet has bled b pay the amount dire Mel dermal, Ttie Wks cd Male Teri Uee Is an eOMCive non and wan to continue the prior* at <br />'9lniwess in the aReNed properly NO* iarpefer <br />7 - 1.1 1 t (402)471.5712 <br />Title Dee Phone Number <br />Revenue Supervisor xe 91.9, 1 ' <br />Tale <br />Revenue Agent <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Ira tars of Sin 1/5 John A Ca 1 e - I1ce in. <br />9 2147 41 356+4 Pigs: 1 <br />CALLEJAS Hewer A <br />Filed: 09104ne14 11:14 AM <br />spouses Soau Security Number <br />come <br />HALL <br />Taxtiayer Nelne and wiling Address <br />Date • <br />4.491.1974 flev,84e13 tr pesmeai 49461974 nes 22Cce <br />