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T�oglaal <br />Tax Period <br />Asa9s °men! <br />Talc <br />Penally <br />Interest <br />Costs <br />Total Due <br />Individual <br />2012 <br />1W1812014 <br />910.75 <br />50.00 <br />81.62 <br />1,101.37 <br />TIXal <br />$1,101.87 <br />2415 3:34PM NE Secretary of State — 4689 <br />U C C „T► <br />dE Sac W 5 *. � � .— i �f a <br />I I I <br />ps'15753610-5 1111 <br />. <br />t F ICR l" 1015 e%2ei5 09:02 Ph <br />May, <br />Nsbreeke Dspsacee a of <br />REVENUE <br />This Nonce of State Tax Lien is issued by the Nebraska <br />Department of Revenue for unpaid taxes administered by time Tax <br />Commissioner. Taxes, Including penalties, interest, and costs, <br />which arc shown below, are due from the taxpayer and remain <br />unpaid after 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 Ilen, This (fan will expire and <br />Decame unenforceable 10 years after the date of recording if no <br />continuation statement is recorded on or prior to the expiration of <br />the prevloue Ilen or continuation statement. <br />Nebraska 1D Number <br />90048808 <br />Ua, Serial Number <br />11550911 <br />Dated Lien <br />05/0512015 <br />sign <br />here <br />Aulhafzed Signelane <br />von Red Me <br />© Regsler or Deeds <br />UenTA* <br />1) 0001 <br />Business Name and Location Address <br />201,0296,1 <br />Notice of State Tax Lien <br />❑ Couny auk <br />❑ Gonda Won <br />PLEASE D0 NOT WRITE IN THIS SPACE <br />Federal ID Nrrntlar <br />Soak/ Seounty Number <br />XXX -XX -8158 <br />CODY T HORTON <br />1821 E CAPITAL AVENUE <br />GRAND ISLAND NE 68801 <br />TAM <br />Revenue Supervisor <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />Spouse's Sold Smoky <br />County <br />❑ooaeded HALL <br />Taxpayer Name and %Ming Address <br />I Candy Ina dm Nowa Deperr eini d naeanue tmo aamplled eat Iho lmro ae Um deb of Mebrmla h delamarang the eriuln down Kyle d e, <br />and that the has laled l0 pis/ the amount due deer danend,Tele Nabs of 8da Tess Lion le an dferSvo wen and same b oweilwa the p,oiiti of <br />ma amb . . d nne <br />Al/ e Z I.V 1 Revenue Anent <br />i bT f k YJ <br />05f0512015 JjprnG32 -1203 <br />Dem Phan Nurrrbar <br />05!05!2015 <br />Date <br />'44.1974P.by 0,21199rpMradm49401974 Rrv.2 -M0R <br />