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v <br />0530!2003 16:33 FAX 14024714429 NEBRASKA LiCC <br />Or <br />tio�� <br />4014ri w <br />of <br />200307048 <br />0002; 003 <br />pea <br />:48 AM <br />NOTICE OF STATE TAX LIEN <br />r <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 specifled <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 />Nebraska Identification Number Lien Filed With I Social <br />PLEASE DO NOT WRITE <br />Spouse's Social Security Number <br />39944670 X❑ Register of Deeds ❑ County Clerk 551 -53 -7366 624 -24 -3908 <br />Lien Serial Number Lien Type Date of Lien County <br />030450372 X❑Orlginal ❑Continuation ❑Corrected 1 05/27/2003 HALL <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Name <br />Guillermo Ramirez & Felipa Torres Ramirez <br />Street Address Street or Other Mailing Address <br />2618 St. Patrick Ave. Apt 5 <br />City State Zip Code Clty State Zip Code <br />Grand Island NE 68803 <br />Tax <br />Category <br />Tax Period <br />t <br />Date of <br />I <br />Amount of Tax <br />Penalty <br />I <br />Interest <br />I <br />Additions <br />I <br />Balance of <br />Number <br />Assessment <br />Assessment Due <br />22 1 1999 1 11/21/2002 1 1,231.66 1 66.00 1 353.60 1 1 1,651.26 <br />I I I I TOTAL J$ 1,651.26 <br />1 hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska In the <br />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 <br />Tax Lien is a extension of an eff five lien, it serves to continue the priority of the state's InteresT the ffected property of the taxpayer. <br />fJ' 402 471 -5835 f <br />Revenue Agent a <br />sign » P rep a f Signature Title Date Telephone Number <br />here 11� Revenue Senior Agent 5- -Z17—ter :17 <br />A horized Signature Title Date <br />4.494 -1974 Rev. 2 -20102 Supersedes 4 -494 -1974 Rev, 1 CL � 995 <br />A <br />1 <br />t <br />1 +' <br />1 <br />A <br />