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01/28/2009 16:47 FAN 14024714429 NEBRASKA L'CC ®002,009 <br />w v.. ..puw - sagt'''•'gg'1•III <br />�f� I 'Au I�IIIII IIIIIIIIIIIII�I�IIII <br />II��Il�llall Pov. t <br />� <br />BaLL3ay3p <br />rtt.a: atraeraaaa .2 12 Pe <br />4Axaaixa <br />NOTICE OF STATE TAX LIEN <br />PLEASE 00 NOT Wl IN THIS SPACE <br />This Notice of State Tax Lien is issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice is hereby given that taxes including penalties and <br />interest, which are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These texas constitute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter ac ulred. <br />NebrrNe Idenllficelbn Number <br />24300179 <br />�Jeh Flletl With <br />❑x Rallies, of Deeds 11 Clerk <br />Social Sedulity Number Spouses social s«unh Numbe. <br />H 503 -54 -3901 <br />508- 30-9197 <br />iev Serial Numbsr <br />003420233 <br />Lim Type Oat. of Lien <br />X❑onginai ❑CwtiOUedon ❑carreotvd 01/24/2003 <br />County <br />HALL <br />BUSINESS NAME AND LOCATION ADDRESS <br />Bueineoe Name <br />' <br />TAXPAYER NAME AND MAILING ADDRESS <br />N.M. <br />NILES A 8 GEORGENE K MILLER <br />S4nef Address <br />SVed or Cther AtXinB Addnr <br />518 WEST STH STREET <br />Clh <br />Stale ZiP Code <br />CXy Slats Zip cede <br />SPAND iGLAND <br />Cal.gory <br />Rumba, <br />72 <br />Tax PeNotl I <br />^.997 <br />Danof <br />"aessmant <br />10/23/2000 <br />Amomdoi Tax Penalty <br />967.00 43.35 <br />Interest <br />AdmOens <br />Balance of <br />AawsameM DUe <br />371.12 <br />1,281.47. <br />TOTAL <br />' —..AV <br />ewrPNhnr Me <br />Ti DepadmeM o! Revenue has card <br />led mh the re venue /ewe of the SteteMNebmak sma _ <br />dMartrina9on fihe emouM Vhwvnt'ba due, and thelaxpaye. bas 911e0 to lay me ameumw emero. �•••�ew � <br />Tax Lien ism c,denion Ofr effactrve lien xserves tO COMinueme, lhorttV O`ihe stak'sinkrea[Intlle enacted property 'thelaxpayar / <br />402 471 -5835 <br />Revenue Ao ent _ / �' 3 — <br />St9n P ne stun TXv pa:e Tnepn reN er <br />here R SubervlsOr °�� <br />� uthorized Sgnatun Titla De <br />9�90.1aW iw9SCRSUyrteer 4ii:19]E FeV. IGi9` <br />