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12,-'20/2001 15:40 FAX 14024714429 NEBRASKA UCC 002:'004 200113193 f' 12:51 pri STL Or Notice of State Tax Lien ne0raska of revenue PLEASE DO NOT "WRITE IN TENS SPACE Please return to. STATE OF NEBRASKA DEPARTMENT OF REVENUE 1811 WEST 2ND ST STE 460 GRAND ISLAND NE 68803 INDIVIDUAL INCOME TAX S ©C. SEC. No. 508720267 NEBRa IDENT, NO, 244=12718 SPOUSE SOC. SEC- NO. TAXABLE YEAR 2000 LIEN MQa 012250195 COUNTY HALL DAVID D LANDIS DATE OF NOTICE 08/17/2001 108 ',-WEST .3RD DATE OF ASSESSMENT 05/30/2001 GRAND ISLAND NE 58801. THIS NOTICE CF STATE TAX LIEN IS ISSUED BY THE NEBRASKA DEPARTMENT 13F REVENUE FOR INDIVIDUAL INCOME TAX PURSUANT TO THE REVENUE LAMS OF THE STATE OF NEBRASKA, NOTICE IS HEREBY GIVEN THAT INDIVIDUAL INCOME TAXES INCLUDING PENALTIES AND INTEREST„ WHICH ARE SHOWN BELOW ARE DUE FRCM THE TAXPAYER SPECIFIED ABOVE AND REMAIN UNPAID AFTER DEMAND- THESE TAXES CONSTITUTE A LIEN IN THE COUNTY FOR PROPERTY BELONGING TO THE TAXPAYER OR HEREAFTER ACQUIRED. AMOUNT OF TAX . a a a a . . . . a . . . . , a • a 21902000 PENALTY i a.• a• a a a,.•.. a a a a a a a 145.10 INTEREST (COMPUTED TO 0811712001) . . . . . . • . 88.73 TOTAL AMOUNT DUE a a a a . e a• a a. i. a a. 3v335i83 I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED WITH THE REVENUE LAWS OF THE STATE CF NEBRASKA IN THE DETERMINATION OF THE AMQUNT SHOWN TO BE DUEL AND THE TAXPAYER HAS FAILED TO PAY THE AMOUNT DUE AFTER DEMAND. IF THIS NOTICE OF STATE TAX LIEN IS AN EXTENSION OF AN EFFECTIVE LIEN IT SERVES TO CONTINUE TH£.PRIORITY OF SHE STATEIS INTEREST IN THE AFFECTED PROPERTY OF THE TAXPAYER• PREPARERIS SIGNATURE TITLE f � 'i ) �'�S W J � �A Ste. \� j'{/_�� /�7 / � f/+�' f j'� Try' / • DATi�E /a T• Ei Lf E■ Pa Ha O• N ✓ AUCZ SIG / RE a , a TITLE DATE NEBRASKA DEPARTMENT OF REVENUE —White and Canary Copies TAXPAYER — Pink Copy Pr:ntad with soy ink Ca radyriedpaper 7.145.1976 Rev. 2 -2000 Sup.rsadas 7.1451S79 Rev. 10 -1995 `