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0210512003 16:24 FAX 14024714429 NFBRASKA ICC 0002/003 <br />DIY <br />File, .311M.3 12-10 W <br />' NOTICE OF STATE TAX LIEN <br />: <br />ME <br />A.SE DO NOT W W TE IN TNB 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 slate 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 />Wow and remain unpaid after demand. The" taxes constitute a lien <br />In the county far real and personal property belonging to the taxpayer <br />or hereafter ataumed. <br />Nahaala IdsttW,,atlgn Number <br />36773786 <br />Lien Flletl Wih <br />QX Re96mreDeeds <br />E(twnrymEr9 <br />Sadel Securt, NumSar <br />505 -78 -9014 <br />Spouse's Scokl Seourlty Numbs, <br />450 -15 -4266 <br />Lien S.rd N,mbar <br />0; <br />Lien Type Date of Len <br />[:]Cpntinua0on F-1cvrmdi <br />eounH <br />HALL <br />BUSINESS NAME AND LOOATIONADDRE38 <br />TAAPATEN NAME AND MAILING AppRESa <br />e'slxss Name <br />Name <br />CARPIC & DIANA CASARES <br />stmel AddNS <br />Sexist r Other Milling Add. <br />514 EAST 6TH <br />City <br />Stele Zip Code <br />ICdy state <br />GRAND ISLAND NE <br />Zlp Cede <br />68601 <br />Tax <br />Category <br />Number <br />Tea Period <br />cahoot <br />Weesemenl <br />Amount of Tax <br />i <br />Penalty <br />Monist <br />Manors <br />Balance of <br />Assessment Due <br />22 <br />2001 <br />05/03/2002 <br />994.00 <br />4870 <br />69.44 <br />1,113.14 <br />I <br />TOTAL <br />$ 1,112.14 <br />I M1xabv <br />cenlNAa the <br />Nebroe W Deganmenl <br />of Rwanw hie mmolletl <br />wdn'he!ewnua laws <br />ofne Slate of Nibraaka In Inc <br />de[ernlnaton olthe emgunl shown Id he tlue, and Ue ter�eyer bee failetl la pay e s snwunt res efl t tle shored II Irk Nadca he Stets <br />Tee Llen is an eMenslo sn Rectiv lien,azerssto ccntinas Me prcrity of mates Interest in the anacatl prolaaty of the taxpayer. <br />�`,�.i1GA7p e� fUIL� Revenue Agent d' -4 -03 402471 -5635 <br />5 Y P rely s' aura n Tile nets Teleplwne Number <br />here r I� Revenue Supervisor <br />AcMor.d S tore ❑OS Cate <br />