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02!27:'2003 08:38 FAX 14024714429 <br />6( /` <br />200302328 <br />IR 003/ 008 <br />I <br />Sao OD el Be Ph <br />NOTICE OF STATE TAX LIEN <br />PLEASE DO NOT WRITE IN THIS SPACE <br />This Notice of State Tax Lien is issued by the Nebraska Department of <br />Revenue for unpaid tuxes pursuant to the revenue laws of the state of <br />Nebraska. Notice Is hereby given that taxes including peaat6es and <br />interest, which are shown below, are due from the taxpayer specified <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 />Ne."s ldmtifi.b. Number <br />"34990880'' <br />Llen Filed WJM _ <br />0Re9Ntroi Deehe ❑county clerk <br />:S.W S.cu,by Number, -: <br />,: 505. 724361 <br />Spouse'. Seew s¢curiy NUmWr <br />Lim Se Number ... ._. <br />IZOO 0032 <br />Lbn. Type. __. 1 ,Date <br />❑XOrgh.l ❑COntlruai0h ❑Corrected, <br />of Len <br />02/14/2003 <br />Cpunty <br />! HALL <br />BUSINESS NAME AND LOCATION AODRMS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />- <br />N.M. <br />DONALD P HAUSSERMANN <br />Stret Addmse <br />Street cr Other Maling Ad&. <br />4954 W WAY 30 #7 <br />wily <br />Steve Zip Cade <br />Cty State <br />ALDA NE <br />Zip Ord. <br />68810 <br />Tax <br />Cxxgory <br />Number <br />Tax Pcrud <br />Dvte of <br />Ane¢ammt <br />Amount of Tax <br />Pentlty <br />Inlera¢t <br />Additions <br />9axnce of <br />Asses Oue <br />22 <br />1999 <br />02/14/2003 <br />33.49 <br />48.58 <br />33.73 <br />115.80 <br />.• <br />TOTAL.._` <br />—_ <br />a x orih six rN a.tl'm <br />S. _ _115.80 <br />IM1ereby ceNfy[M1at Me NeMeelyd DepaNneN pl Revenue has compAe wAM1 ;he revenue w. e a a e aem e ' <br />- dexrmLLle5en -a��tthe anaurt shown[o be due. antl Me xxya>er has feBetl h, pay rie arrount dux a(im dement I(Ihla Notice of State ��C <br />Taa LIen Is an ,h i I dive !n, I ies x time rie prurity o(Me states iNemsl in�Me�fect`ed% perry el the xlmayer. {� <br />Revenue Apent �_1r�re/n� 402 471 -5835 <br />sign P�apa..sBm //nne <br />here �l.,eriC Revenue supervisor <br />/i Ilimimd Sltnatu Title D;e <br />a<va.+w <e�. rzooz a,pe, =me s<e <rcva nr. m - sss <br />