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201503877
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6/10/2015 3:30:10 PM
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6/10/2015 3:28:10 PM
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201503877
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ax imtt <br />Tax Period <br />Ass of <br />Tax <br />Penalty <br />Interest <br />Costa <br />Tetai Due <br />individual <br />2009 <br />10/1012 <br />216.96 <br />10.85 <br />45.31 <br />273.12 <br />Total <br />3273.12 <br />Jun.10 2015 3:03PM NE Secretary of State — 11CC <br />Nebraska tkpartmeat o1 <br />REVENUE <br />This Notice of Stets Tee Lien is 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 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 Iien.This lien will expire and <br />become unenforceable 10 years after the data of recording if no <br />continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation elaMmartl. <br />Nebraska ID Numbst <br />97128886 <br />Lien Serial Numbs <br />11552719 <br />uon Rleo Wth1 <br />Reoeter odm,* ❑ cvr*yow, <br />Deis of Lien Lk t 1 pe: <br />06108(2015 gur s ❑ corn.war' <br />Business Name and tocadnn Address <br />sign <br />here <br />20 1503877 <br />Notice of State Tax Lien <br />PLEASE DO NOT WRITE IN TINS SPACE <br />Federal Member <br />Social Smelly Number <br />l00( -1IX -4150 <br />0 Cmreseed <br />RACHEL L CARAVAN <br />967 50TH AVE <br />GREELEY CO 80634 <br />Soo of Slots Jahn 11 iota - u[G STL <br />1111111111 I <br />9915755166 -2 Pas. 1 <br />!Annum RA 4EL L <br />Feud! 06/10(29i5 11:19 AM <br />Spoueeb Social Security Wii to <br />Gent <br />HALL <br />r Name and gent • Address <br />No. 1241 ?. 2 <br />testify that he Menem Depilat :A of Revenue has compNsd with Ise Lass of eta Slats o1 Ne waste Y1 dlrtanidng the amount sham In be dug, <br />and thst the u>gesysr tree rated to per entoms We she demand. This %doe of Star Thx ben Is an et? cdee len end serves to Mime the pdadt. d <br />Ins s interest In asxud property d the tarmac <br />Aw, <br />Revenue Agent 0810B2015 0O2)471.5928 <br />The bete Mena Nt6Kf <br />Revenue Supervisor 0610812015 <br />The bee <br />4-494-19N F1,. 610133epeRede4 4461974 Ram. 24092 <br />
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