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02/05/2004 17:06 FAX 14024714429 NEBRASKA UCC 2 0 0 4 0 115 <br />webraska Notice of State Tax Lied --Z <br />• - Irepartmenl <br />1 of revenue <br />INDIVIDUAL INCOME TAX <br />SOC. SEC. NO. <br />NEBR. IDENT. NO. <br />SPOUSE SOC. SEC. NO. <br />TAXABLE YEAR <br />LIEN NO. <br />COUNTY <br />DATE OF .NOTICE <br />DATE OF ASSESSMENT <br />480 -88 -9476 <br />36458430 <br />1990 <br />940210007 <br />Hall <br />05/03/94 <br />04/06/93 <br />IM 007 <br />94, 10` 717 <br />Thomas Larson <br />517 E 11thISt <br />Spencer IA 51301 <br />THIS NOTICE OF STATE TAX LIEN IS ISSUED BY THE NEBRASKA DEPARTMENT OF <br />REVENUE FOR INDIVIDUAL INCOME TAX PURSUANT TO THE REVENUE LAWS OF THE <br />STATE OF NEBRASKA. NOTICE IS HEREBY GIVEN THAT INDIVIDUAL INCOME <br />TAXES INCLUDING PENALTIES AND INTEREST, WHICH ARE SHOWN BELOW, ARE DUE <br />FROM THE TAXPAYER SPECIFIED ABOVE AND REMAIN UNPAID AFTER DEMAND. <br />THESE TAXES CONSTITUTE A LIEN IN THE COUNTY FOR PROPERTY BELONGING TO <br />THE TAXPAYER OR HEREAFTER ACQUIRED. <br />AMOUNT OF TAX . . . . . . . . . . . . . . • . • $ 399:00 <br />. <br />PENALTY . 324.75 <br />INTEREST (COMPUTED TO 05/03/94 ) • • • • • • • • . . . 391.14 <br />TOTAL AMOUNT DUE . . . . . . . . . . . . . . . . . . 1,114.89 <br />I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED <br />WITH THE REVENUE LAWS OF THE STATE OF NEBRASKA IN THE DETERMINATION OF <br />THE AMOUNT SHOWN TO BE DUE, AND THE TAXPAYER HAS FAILED TO PAY THE <br />AMOUNT DUE AFTER DEMAND. IF THIS NOTICE OF STATE TAX LIEN IS AN <br />EXTENSION OF AN EFFECTIVE LIEN IT SERVES TO CONTINUE THE PRIORITY OF <br />THE STA 'S NTEREST IN THE AFFECTED PROPERTY OF THE TAXPAYER. <br />OA <br />•� - <br />REPARER S NATURE TITLE DATE /TELEPHONE <br />AUTHORIZE S GNATURE TITLE ��•� <br />DATE <br />FOR COUNTY OFFICIAL'S USE <br />M. <br />z;v <br />< rn <br />m� <br />r— C <br />z <br />m <br />0, <br />NEBRASKA DEPARTMENT OF REVENUE— White and Canary Copies <br />f0 prrnfed on recyded paper <br />TAXPAYER Pink Copy- COUNTY -- Goldenrod Copy <br />7- 145 -79 Rev, 5 =91 <br />SLpwSedes 7- 145 -79 Rev. 6 -90 <br />v <br />r <br />2 <br />cn <br />�' �• <br />i�:7 <br />r <br />c <br />1 <br />y <br />m <br />G� <br />� <br />G•7 <br />c <br />TAXPAYER Pink Copy- COUNTY -- Goldenrod Copy <br />7- 145 -79 Rev, 5 =91 <br />SLpwSedes 7- 145 -79 Rev. 6 -90 <br />