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08/31/2004 14:30 FAX 14024714429 ._ a 1 j�1 f NEBRASKA UCC 200408705 191005/006 Notice of State Tax Lien Or nebtaska deDartm9nI 0i revenue PLEASE DO NOT WRITE IN THIS SPACE INDIYIDUAL INCOME TAX soc e SEC. 900 50"Y" 12673 NEBR. IDENT• 9 -00 32869835 SPOUSE Su%• SEC, No. TAXABLE YEAR 2000 CGUNTY BALL JASON L ARNETT DATE OF NOTICE 05/30/2003 2129 E WILDWC D DATE OF ASSESSMENT '- 4/l */f2003 GRA14D ISLAND ME b880 T R NOTICE Of STATE TAX LIEN IS A.SSUED ZY THE NEBRASKA € EPARTMENT OF REVENUE FOR. INDIVIDUAL INC RE TAX PURSUANT TO THE REYEiUL LAWS OF THE STATE OF NEBRASKA- NOTICE IS HERESY GIVEN THAT INDIVIDUAL INCOME TAXES INCLUDING PENALTIES AND INTERESTs WHICH ARE SHOWN BEL3W'ARE DUE FROM THE. TAXPAYER SPECIFIED ABOVE AND REMAIN UNPAID AFTER DEMANDe THESE TAXES CONSTITUTE A LIEN IN THE COUNTY FOR PROPERTY BELONGING TO THE TAXPAYER OR HEREAFTER ACQUIRED* AMOUNT OF TAX PENALTY . • • r • , a . . . • . • r . • • • • • • s•4Q INTEREST ('COMPUTED TO 5/30/2003) , . 30.03 TOTAL ARGUNT DUE • . r • . . . • . , . . , . 206643 I HERcBY CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED 41TH THE REVENUE LAWS OF THE STATE Cif NEBRASKA ' IN THE DETERMINATION OF THE E AMOUNT SHOWN TUBE DUE9 AND THE TAXPAYER HAS .FAILED TO PAY THE AMOUNT DUE AFTER DEMAND, IF THIS NOTICE OF STATE TAX LIEN ZS AN EXTENSION CF AN EFFECTIVE LIE? IT SERVES TO C13NTINUE THE PRIORITY OF THE STA a c' S INTEREST ;N THE AFFEC T E? PROPERTY OF TiE TA7'AfcR, PREP RF_R *S SI— ! Rc t I31c w . a.a .i.•..••.•. iTHORIZE SIGNATURE TITLE E �y a DATE /TELEPs 0;# .5�a.�fis�r+a•ar••a•s•" DATE. : `f r; f_ � L% NEBRASKA DEPARTMENT Printed with soy ink on recycled paper OF REVENUE — White and Canary Copies TAXPAYER — Pink Copy 7- 145 -1979 Rev. 2 -2000 Supersedes 7-1451979 Rev. 10 -1996 It