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03/23,/2004 10:56 FAX 14024714429 NEBRASKA OCC <br />L (� <br />20040'814 <br />Please forward to: <br />Nebraska Department of Revenue <br />4500 Ave I PO Box 1500 <br />Scottsbluff, NE 69363 -1500 <br />or <br />a „w' <br />Q002 <br />1111111 P.8 1 <br />VILL 4e T <br />RqILL Baft', G <br />F1Ltl: BBHO 2004 00:09 PM <br />Notice of State Tax Lien <br />PLEASE DO NOT WMM IN THIS SPADE <br />INDIVIDUAL INCOME TAX <br />,SO6+ SEC. Nu. 410027458 <br />HEBR. IDENT. NO. 41726154 <br />SPOUSE Soce SEC. No.. <br />TAXABLE YEAR .2001 <br />LIEN: W. 040090060 <br />COUNTY gall ROBERT �D HILL <br />DATE. Of R07ICE 01/9,9/2004 5511, HIGHWAY 280 '.E SUITE 220 <br />DATE OF ASSESSMENT 10/01/2003 BIRMINGHAM AL 35242, <br />THIS NOVICE OF STATE TAX LIEN IS ISSUED BY THE NEBRASKA DEPARTMENT OF <br />REVENUE FOR INDMDUAL'INCUHE TAX PURSUANT TO THE REVENUE LATHS 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 DEMA ND. .. <br />THESE TAXES "CONSTr*tE "A. :..LIEN IN`THE "COUNTY MR PROPERTY ":BELONGING TD <br />-: - -. .. <br />THE TAXPAYER - OR' HEREAFTER : ACQUIRED. <br />AMOUNT OF TAX'. . . . . . .7 {7465.60 <br />PENALTY . -... . .,.. - . -': <br />INTEREST {COMPUTED TO DI/0412004) . • .975.20 <br />TOTAL AMOUNT. DUE .'.. .. .. . . . .- 101681:45 <br />1 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 NTDDUE SHOWN 7O BE DUES <br />AMOUNT AND THE TAXPAYER HAS FAILED TO PAY THE <br />T. 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 STATEIS INTEREST IN THE. AFFECTED�PRDPERTY OF THE TAXPAYER. <br />Jr2/�l 1 <br />PREP IS. :. Rk , 1.:. ' ( %3�81t°i3.:.. <br />DATE /TELEPHOHE / <br />UTHOR ZED 5iGNATURE Tto -- - >DATF <br />.11 <br />NEBRASKA DEPARTMENT OF REVENUE White and Canary COPIM TAXPAYER— PM CWV. <br />PMYtl:�ny Mkm�eEPoP. '1 19518]8 RN)R2W811 -vnpY. 1- 1<S1BlBR OI:�Q. i' <br />