200409275 - Laserfiche WebLink

Browse

09!17/2004 16:35 FAX 14024714429 NEBRASKA UCC Or 200400275 9002/004 STL Pas: I PM NOTICE OF STATE TAX LIEN PLEASE DO NOT WRITE IN THIS SPACE This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are shown below, are due from the taxpayer specified below and remain unpaid after demand. These taxes constitute a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. Nebraska Identification Number Lien Filed With Social Security Number Spouse's Social Security Number 32816685 N Register of Deeds E] County Clerk 508 -90 -5173 Lien Serial Number Lien Type Date of Lien County 022070258 XD Original [:]continuation Corrected 07/22/2004 HALL BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name Name CANDI L GAFFEY Street Address Street or Other Mailing Address PO BOX 421 City State Zip Code City State Zip Code W0017) RIVFR IVF RRRR3 Tax Category Tax Period I Date of I Amount of Tax Penalty Interest Additions Balance of Number Assessment Assessment Due 22 I 2001 1 05/ 10/2002 I 643.53 I 73.70 1 107.77 I I 825.00 I I I I TOTAL I$ 825.00 1 hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in the determination of the amount shown to be due, and the taxpayer has failed to pay the amount due after demand. If this Notice of State Tax Lien i an �extension of an a ective lien, it serves to continue the priority of the state's interest in the affected property of the taxpayer. sign Revenue Agent 402 471 -5835 , g Prep igna Title Date Telephone Nurnber here 111. 6 ' A omed Signature Title Date