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03'11!2003 17:41 F.." 14024714429 L" IM 003!00:1 STL laiiii[lil 11111111 Fw.r03'llj2N3 03.26 PM 200302898 Or Notice of State Tax Lien mbneke tlaPew^em onen.m PLEASE 00 NOT WRITE IN TMS SPACE INDIVIDUAL INCOME TAX SOD. SEC. NO. 505228286 NEBR. IDENT. NO. 16925351 SPOUSE SOC. SEC. NO. TAXABLE YEAR 2000 LIEN NO. 0304�.g50094 COUNTY NA LG ERNA E THAGARD DATE OF NOTICE D2/1412003 1419 W LOUISE DATE OF ASSESSMENT 11/12/7002 GRAND ISLAND WE 68601 THIS NOTICE OF STATE TAX LIEN IS ISSUED BY THE NEBRASKA DEPARTMENT OF REVENUE FCR INDIVIDUAL INCOME TAX PURSUANT TO THE REVENUE LAMS OF THE STATE OF NEBRASKA. NOTICE IS HEREBY GIVEN THAT INDIVIDUAL INCOME TAXES INCLUDING PENALTIES ANDINTEREST♦ WHICH ARE SHOWN BELOW ARE DUE FROM THE TAXPAYER SPECIFIED ABOVE AND REMAIN UNPAID AFTER DEMAND. THESE TAXES CONSTITUTE A LIEN IN THE COUNTY FOR PROPERTY BELONGING TO THE TAXPAYER OR HEREAFTER ACQUIRED. AMOUNT OF TAX . . 349.00 PENALTY . . . . . + . . . 106.25 INTEREST (COMPUTED TO 02/1412003) . . . . . 56.37 TOTAL AMOUNT DUE . . . . . . . . 511.62 I 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 IS AN EXTENSION OF AN EFFECTIVE LIEN IT SERVES TO CONTINUE THE PRIORITY OF THE STATERS INTEREST IN THE AFFECTED PROPERTY OF THE TAXPAYER. �: h%%�r� '.fJ !:�:... ....... iPJOa s PR ARE •S SIGNATURE TITLE DATE /TELEPHONE .. ��. ..a3 LkIA-3........ " AUTHORI D SIGNATURE TITLE DATE NEBRASKA DEPARTMENT OF NEVENLIE — WNW and Canary Cc . TAXPAYER — R4 Copy PMbe'nM .or;�. a, wer�ee wc.< T- •.+s..sre re..aaus.P.r..ee. r.; w;e+s a... io..eas F-