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11/02/2001 09:21 FAX 14024714429 NEBRASKA LCC 0 200111251 U002/002 � Notice of State Tax Lien �r neeraetra tleperl.rrent d rNMNre This Notice of State Tax Lien Is issued by the Nebraska Department or Revenue for unpaid taxes pursuant to the revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are shown below, are due from the taxpayer specified below and remain unpaid after demand. These taxes constitute a Ilea in the county for real and personal property belonging to the taxpayer or PLEASE DO NOT WRITE IN THIS SPACE ..... moo....... Nebraska Ideri llcation Number 8133794 _ Lien Fled With ® Register of Deeds ❑ County Cleric Social Security or Federal I.D. Number 507-04-9740 Spouse's Social Security Number Lan Serial Nurnber 01/10/302 Uen Type Date of lien ® original ❑ Continuation ❑ Corrected 10-30-01 County HALL BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND IN UNO ADDRESS ausiness Name THE OASIS Name GARY R LEMBURG Street Address 205 E HWY 2 Street or Other Ideifng Address 1322 W EIGHTH ST city State Zip Code CAIRO NE 68824 City State Zip Code GRAND ISLAND NE 68801 Category 01 Tax Period -Oi- 07 -31 -01 Data of A�a�1tROtit 09 -19 -01 Amotmt o1 Tax 1526.75 Penalty 152.67 Interest 37.11 Addltlott8 Balance of Assessment Due 1716.53 ' Plenu return to: STATE OF NEBRASKA DEPARTMENT OF REVENUE 1811 WEST VD ST STE 460 GRAND ISLAND NE 68803 • TOTAL 1716.53 $ I hereby certify that the Nebraska Department of Revenue hae complied wtm the revenue yaws of uie craw a Nvuresxa rn ure ae[arrnnauvi l of the amount shown to be dr.e, and the taxpayer has tailed to pay the amount due after demand. If this Notice of State Tau L1en is an extension of en aft 1 d serves to continue the priortty, of the state's esit in the affected property of the taxpayer. sign h e re Preparies siptawre / 'roe Dam Telepno � No. tr®