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T rn D � <br /> n � � � _ <br /> � <br /> 2 D p �, <br /> C1 N cn ,� � �� <br /> 7C ,� , .-.{ <br /> � �y �� <br /> � o � G..� ""f � <br /> y(' � (1 \ P� � .' � ro <br /> �� � <br /> . � `il �'� `G .. X., p r'1 "a <br /> CU <br /> 6'>h�, .3� `l.r � <br /> n 1�� "'�' "�l iwY. S'� � <br /> � ("�7 N <br /> � � <br /> ;• . <br /> . 9 ��, �. �� �� <br /> ;-< <�, s�. ..�„ � <br /> 9,��s�s 7 �, �: : �n �. <br /> - N ' �� :.� � � <br /> � � �� � � <br /> ...., �;� cn �. <br /> . �N,� . ° � <br /> � Not�ce of State Tax L�en � <br /> �Ir <br /> � � <br /> �� <br /> �..,,.�,�. . <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. Nottce is hereby given that taxes including penalties and <br /> interest, which are shown below, are due from the taxpayer speci8ed <br /> below and remain unpaid after demand. These taxes constitute a lien in <br /> t6e county for real and personal property belonging to the taxpayer or <br /> hereatter acquired. <br /> Nebraska IdenGfication Number Lien Fled Wfth Social Securily or Federal I.D.Number Spouse's Social Securily Number <br /> 3 8 i 3 9 2 5 9 Res��cer ot oeeds ❑courny cieric 4 6 2—2 9—5 7 7 4 <br /> Lien Serial Number Lien Type ` � Date of Lien Courriy <br /> 9 06 357 °"9'"a' ��O""""��0" ��0f��� 06-08-1999 HALL <br /> BUSINESS NAME AND LOCATIQN ADDRESS TAXPAYER NAME AND MAIUNG ADDRESS <br /> Business Name Name <br /> ANTHONY ORTIZ JR <br /> Street Address Street or Other Mailing Address <br /> 501 N COLORADO AVE APT 1 <br /> City Shate Zip Code City Shate Zip Code <br /> HASTINGS NE 68901 <br /> Tax <br /> Cetsgory Tax PeNod �� Amount of Tax Penalty IMsrest AddRions �s�Due <br /> Number <br /> 22 1995 02-24-99 1334. 00 66. 70 377.94 1778.64 <br /> TOTAL $ 1778.64 <br /> I hereby certify that the Nebraska DeparbneM of Revenue has complied with the revenue laws of the State of Nebraska in the determination <br /> of the amourrt shown to be due,and the taxpayer has failed to pay the amouM due after demand. If this Notice of State Taz Lien is an extension of <br /> an effectiv lien,it serves to coMinu priority of the scate's irrterest in the affected property of the taxpayer. <br /> sign � ' — - c3o8�3�5-GoZS— <br /> here �rer's ' na T �te T� No. <br /> orized Sig e Title Date I <br /> NEBRASKA DEPARTMENT OF REVENUE-White and Gold rod Copies TAXPAYE -Pink Copy COUNTY OFFICE-Canary Copy <br /> (�PN'�p^^wY�'�P+M� 449474 R9v.1495 SupeBed9a 4-49474 Rev.5-95 <br />