Laserfiche WebLink
02/25/2004 12:15 FAX 14024714429 1 NEBRASKA UCC IM 002/005 <br />Please raturnto: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2''r° ST STE 460 <br />GRAND ISLAND NE 68803 <br />exDrosk► <br />a4ai�irr�nf <br />Nit Inc of Sioto - UCC STL <br />I <br />Fi 0 S L I NDR 2004 09:21 pN s t <br />NOTICE OF STATE TAX LIEN <br />PLEASE DO NOT WRITE IN THIS SPACE <br />This Notice of State Tax Lien 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 hereby given that taxes including penalties and <br />interest, which are shown below, are due from the taxpayer specified 200401664 <br />. <br />below and remain unpaid after demand. These taxes constitute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter acquired. <br />Nebraska Identification Number Lien Filed With Social Security Number Spouse's Social Security Number <br />99767732 XO Register of Deeds [_] County Clerk 512 -76 -0181 <br />Lien Serial Number Lien Type Date of Lien County <br />032270800 Original D Continuation Q Corrected 02/11/2004 Hall <br />BUSINESS'NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Name <br />Linda S Ellis <br />Street Address Street or Other Mailing Address <br />2060 Nielsen Court <br />City State Zip Code ( City State Zip Code <br />Colorado Sorinas CO 80906 <br />Tax <br />Category <br />Tax Period <br />Date of <br />Amount of Tax <br />Penalty <br />Interest <br />Additions <br />I <br />Balance of <br />I <br />Number <br />Assessment <br />Assessment Due <br />22 2002 05/23/2004 265.00' 13.25 13.15 <br />291.40 <br />TOTAL $ 291.40 <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in the <br />determination of the amount shown to be due, and the taxpayer has failed to pay the amount due after demand. If this Notice of State <br />Tax Lien. i next ion of anAeff pti a en, it serves to continue the priority of the state's interest in the affected property of the taxpayer. r <br />TSS ! 2" 308 385 -6067 <br />sign rs Signature Title Date Telephone Number f' <br />here Revenue Supervisor <br />Autho ¢ g t e Title to <br />4- 4941974 Rev. 2 -2002 supersedes 4- 494 -1974 Rev. 10.1995 <br />