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09!12!2000 08:39 FAX 14024714429 NEBRASKA UCC Z002/005 <br />.fir <br />nebrooM <br />ofrevsnus <br />Please Return Original Copy to the <br />Nebraska Dept. of Revenue at 200 <br />South Silber, North Platte, NE <br />691011 NE Sue eF 54�1u UCC <br />111111111r1f 11111I1N1 IIIII I�lI� III ►lI <br />2028 pys 1 <br />FRRed' 09/11/2000 02.26 oft <br />Notice of State Tax Lien <br />PLEASE DO NOT WRITE IN THIS SPACE <br />This Notice of State Tax Lieu Is issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice is hec+ehy given that taxes Including penalties and <br />Interest; which are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These taxes constitute a lien in <br />the county for real and personal property belonging to the taxpayer or <br />hereafter acoufred. <br />2834b815 <br />® Aegiste of Deeds ❑ County Clerk <br />hocnat saoudty or Federal I.D. Numt <br />t.ie0 Serial Number <br />Lien Type <br />505 -90 -1305 <br />002450111 <br />Date or uen <br />® Original El ❑Corrected <br />09 -07 -00 <br />BUSINESS NAME AND LOCATION ADDRESS <br />Busine Name <br />ss <br />TAXPAYER NAM <br />Name <br />Street address <br />Karen A. Harris <br />Street or Other Mailing Address <br />city Sta te <br />1 607 Ho St <br />2fp Code <br />Grand Island <br />ax <br />Catapory Tax Period <br />Number <br />Dab of Amount of Tax <br />Atweaamertt <br />Penalty Intsraat <br />15. <br />Hall <br />AND MAILING ADDRESS <br />.-W Tip Code <br />NE 68801 <br />Additions Balance of <br />�L Assessment Due <br />325.7 <br />i here p compiled TOTAL $ . 325.7 <br />by certify that the Nebraska De artmant of Revenue has with the revenue laws of ire State of Nebraska In the detedm Won <br />u} the amount shown to be due, and the taxpayer has failed to pay the amount due after dernand. If this Notop of State Tax Lien is an extension of <br />man ect" lien serves m nue the priority Of the state's interest in the attested property at the taxpayer. <br />sign <br />here r e <br />Tine Date elephon. o, — 4 <br />- Title Date <br />�NEBRASKA DEP MENT O E - White and Goldenrod Copies TAXPAYER - Pink C <br />tare.d m ��cre MW aPY COUNTY OFFICE - Canary Copy <br />4- 484.74 Rev 1406 SupwWdMg "g4-74 4w. 6- <br />