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02/19/2003 17:15 FAX 14024714429 <br />la 003 /005 <br />L a upII p fII ..... A <br />I- f YI I I I u I gI , I I I I I I tt IXI I II fI I I II II' � iV II I p I I I I I I I III I I I It v' I' <br />u <br />F1 J.d: 92112121241 6 8 00 21 AN I I I <br />200302023 <br />NOTICE OF STATE TAX LIEN <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 spec(ged <br />below and remain unpaid after demand. These taxes constitute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter acquired. <br />PLEASE DO NOT WRITE IN TNIS SPACE <br />Nebaslro ltlantdcdicn Nu ovi <br />41329252 <br />Lien Fled Wlr <br />QRegiatermDeeda ❑Ceunyclvk <br />S,pial Seoltty N—W' <br />461 -57 -4898 <br />Spouss's Social Sacurly Ni,hni <br />Lien Serial Number <br />011800043 <br />Lien Type Cede of Lien <br />❑X Original ❑Continuation ❑corrected 02 -12 -03 <br />County <br />HALL <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILWD ADDRESS <br />Busra. Nerve <br />Name <br />DELIA S OLNARF2 <br />Street Adi <br />Street or OMer Mdli!g Adores. <br />249 EAST 77H ST <br />City State Zip Coda <br />Cny State Zip Code <br />GRAND ISLAND NE 68801 <br />Tax <br />j category <br />Number <br />Tax Period <br />Date of <br />Assessment <br />Amount of Tax <br />Penalty Interest <br />Addebna <br />Be.'ceof <br />Assessment Due <br />22 <br />1998 <br />05/14/2001 <br />331.30 <br />15.55 112.28 <br />459.83 <br />I <br />TOTAL <br />S 459.83 <br />I hw-efv epMN that the <br />Ne iasla De.admop of Revenue has comoled <br />wlh the re®nue laws of the Stet, of Nebreeke in the <br />determinarkn o! tee anoint seown to M tlue, ann tee bxpayxr has p-io to of t the amount tlue offer demeate thoD ly oe of Stele <br />Tax lJe!ISa mansan of eneG,Ne Min .serves!omnAnue the p-iodly.(tM1e date'. intertat in the dbctad oropedy of too taxpayer. <br />1 7 Revenue Agent 02-12 -03 402 471 -5835 �1 <br />Sign 1 reYS nfle Doh Talepiw Num — <br />here Revenue Supervisor 1 /3 d" 1- <br />A orlsd Slgnetwe Pti. Date <br />...s�ra/a ax2xo:u suan.aeee. �- oaaveue...tr.rz.- <br />