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Program Tax Progran <br />Tor: Period <br />F <br />Aaeeasmant <br />Tek <br />Penalty <br />_ <br />Interest <br />Costs <br />TOmI Due <br />Individual <br />2009 <br />0710312012 <br />3,064.10 <br />186.35 <br />618.22 <br />3,850.67 <br />Total <br />53,050.67 <br />Sep,22, 2014 2:30PM NE Secretary of State — UCC <br />N ruk O i "�- - <br />Nehrask4 t7epvtelent of <br />REVENUE <br />This Notice oI State Tax Lien la Issued by the Nebraska <br />Department 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 alter demand.These taxes are a lien 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.TNs nen will expire and <br />become unenforoeable 10 years after the date of recording if no <br />continuation statement Is recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />Nebraska C) Number <br />45582815 <br />lien Serial Number <br />11439982 <br />Dale or Lien <br />09/1812014 <br />sig <br />here <br />odZed SlpnatlK9 <br />Lien FiledtMh <br />® Regained Death ❑ Conti! Clerk <br />Lien Type: <br />Business Name and Location Addres <br />20140602 <br />Notice of State Tax Lien <br />PLEASE DO NOT WRITE INTHIS SPACE <br />Federal ID Number' <br />Social Secety Number <br />XXX - XX -7033 <br />CuriMtelion D Corroded <br />CASEY T CAMPOS <br />922 E 12TH ST <br />GRAND ISLAND NE 68801 <br />Revenue Agent <br />Tie <br />NE Soo of Stain John A e.1 - IYC 1TL <br />I 111111 <br />V <br />V <br />991474229z -4 Ise: 1 <br />FFLL1eeds 0912 22/2014 11;22 AM <br />No 6779 P, 2 <br />Spauae'a Social Seeurify Memher <br />COUdy <br />HALL <br />Taxpayer Name and MIN 9 Aridness <br />J <br />!calk Wet alp Nebraska Deparmsn! of Revenue tee candled r41h Its laws of the Stets of *Weeks In 4 lemrining the amount shown 10 be due, <br />and au the 1aapapar has Ihged to par Its ,minor a e elleftlerllafii This Notice of State Tel Lien le an elracti a ren and Mow to oonin ua the txtedy of <br />the ' in interest in the affected property of the Iaxparyer. <br />8 (402)471 -5712 <br />Dale Panne Number r, <br />Revenue Supervisor p - /j <br />The <br />Date <br />4- 54.11Th Flan 4.x913 Sepveeae4 4- 961974 oar, <br />