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07/23/2004 16:46 FAX 14024714429 NEBRASKA UCC 141002 <br />!Y <br />Or <br />nebraska <br />department <br />of revenue <br />Sacs SEC. no. <br />XEBrR• 'I' DENTa NOe <br />SP SE SO'• SEC• 400 <br />TAXABLE YEAR <br />LIEN, 930 <br />CMTY <br />DATE OF N- '• -TICE <br />DATE OF ASSESSMENT <br />200407336 <br />STLI <br />111111 11 <br />Put: 1 <br />:10 PM <br />Notice of State Tax Lien <br />PLEASE DO NOT WRITE IN THIS SPACE <br />IWI.VIDUAL INCO TALC <br />SZST612# <br />43#98213 <br />2001 <br />040"0380 <br />PALL <br />02/13/2W4 <br />12/316/200-3 <br />L€.NEA M COLLINS <br />IT E LAME <br />GRAND ISLAND NE 68W3 <br />THIS NOTICE Wr STATE TAX LIEN IS ISSUED BY THE NEBRASKA DEPARTMENT .OF <br />REVENUE FOR INDIVIDUAL INCOW TALC PURSUANT TO THE REVENUE LAWS OF THE <br />STATE 13f MBRA-SXA! NOTICE I5 HEREBY GIVEN THAT INDIVIDUAL INCOME. <br />TAXES INCLUDING PENALTIES AND INTERESTS WHICH ARE SHOWN BEi.t'iW 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 ACQUTRED9 <br />AMOUNT OF TA� 259000- <br />PENALTY • ♦ • sw ! • s�y9 *s jw 0x00 `5 <br />f s • i s • • s 1209 <br />+ r <br />TOTAL AMOUNT Dt& + • a • • • w s s ! 3k' 5.971 <br />1 HEREBY CERTIFY THAT THE NERRASX.A OEPA;TJ;E�3 2; REVENUE HAS COMPLIED <br />WITH THE REVENUE LAWS OF rdE STAVE OF NEBRASKA IN THE . DETER1141MATIUN OF <br />THE A WNT SHOWN TO BE DUES AND THE TAXPAYER,HAS FAILED TO PAT THE <br />AMOljjNT DUE AFTER DEMAND• IF THIS NOTICE OF STATE TAX LIEN TS AN <br />EXTENSION OF AN EFFECTIVE LIEW IT SERVES TO CONTINUE THE. PRIORITY 'OF <br />THE STATE'S INTEREST IN THE AFFECTED PROPERTY OF THE TAXPAYERS <br />a • ♦+ •• sr + +•ww +w•• +♦ w• • +0000• w+L's•ra'fiiJn•4r•••••f <br />PREP RER;S Si .' RE TITLE DATE /;ELEPji0 -N; <br />s � s • •♦ �fti�•♦w•f : �i /s Sri sas•• ll+ff!•i •�fill+w•w•�� V <br />A NORI'_E. SIGNATURE T a i L` DATE <br />NEBRASKA DEPARTMENT OF REVENUE -White and Canary Copies TAXPAYER - Pink Copy <br />P&W with soy ink an recycled paper 7.145 -1979 Rev. 2 -2000 Supersedes 7- 145.1979 Rev. 10 -1995 <br />