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07/28/2004 16:59 FAX 14024714429 Or nebraaka department of revenue NEBRASKA UCC Q004/004 200407405 0 STL I� 11I Poe: i 3 PM Notice of State Tax Lien PLEASE DO NOT WRITE IN THIS SPACE I* DIVIDUAL THCOPFE TALC Saco SEC* No, 50715672I NEBRa IBENTo NO, 3T593382 SPOUSE ,S0Co SEC- NO* TAXABLE YEAR 2000 LIEN Nos 04044 -I87 CUUNTY HALL NATHAN L PEASE DATE NOTICE .02113/20.04 2104 W DIVISION APT 3 DATE OF .ASSESSWENT 1211812 404-3 &RAND ISLANID NE SB$03 THIS RMCE OF STATE TAX LIEN IS ISSUED SY THE NEBRASKA DEPARTMENT QF REV -RUE FOR INDIVIDUAL IMCCWX "TAX PURSUANT TO THE REVEMWE LAWS OF THE STATE OF NEBRASKA- NUTiICE IS HEREBY SIYEN THAT INDIVIDUAL INCOME TAXES INCLUDING PENALTIES AND 'T TERESTs WHICH ARE SHOWN BELOW An DUE FROM THE TAXPAYER SPECIFIES ABUVE AND RENAIN UNPAID AFTER DEMAND. THESE TAXES Cr NSTIT'UTE A LIEN IN THE COUNTY F13R PROPERTY BELONSING " TC THE TAXPAYER OR HEREAFTER ACQUIREDo AMMMT .3F TAX a a. a i a s a a a w r 19023.00 PENALTY a a a a a a a 0 a a. o a a a *,a 0 * r s a 511!15 INTEREST ( C�PUTED TO 02/13/20 04) a : a a . a a 225:44 TOTAL A14OUN -T DUE a : a a a. a a a. a a a 12300.159 I HEREBY CERTIFY TMAT THE NEBRASKA DEPART'HENT OF REVENUE HAS CORPLIED WITH THE REVENUE LAWS OF THE STATE OF NEBRASKA IN THE DETERMINATION UF THE AMOLINTSHOWN TO BE DUE, AND THE TAXPAVER,HAS FAILED TO PAY THE AMOUNT DUE AFTER DENARD. IF THIS NOTICE OF STATE TAX, LIFIN IS AN EXTENSION OF AN EFFECTIVE LIEN IT SERVES TO CONTIMME THE PRIORITY OF THE STATERS INTEREST IN THE AFFECTED PROPERTY OF THE T'AXPAY'ER= a a;l fasi# • one .#iaa o a i#-� v 00 PREP EROS SI NA ° r-E TTTLE DAT'EITP3rPHONE �i � — i"�a�si4ti-s ra ►Tisasra a�i�+iLs�yfaaasraa>.v " - -- A T R.IZ SIGNATURE TITLE DATE 1 NEBRASKA DEPARTMENT OF REVENUE — White and Canary Copies TAXPAYER —Pin opy Printed wRh soy ink an recycled paper 7- 145 -1979 Rev: 2 -2000 Supersedes 7 -145 -1979 Rev. 10 -1995