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03/07/2002 16:39 FAX 14024714429 NEBRASKA OCC 9003,003 <br />Or <br />d.arae.ne <br />Notice of State Tax Lien <br />This Notice of State Tax Uen.Is issued by the NIChMSlm 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 specified <br />below and remain unpaid after demand. These taxes constitute alien in <br />the county for real and personal property belonging to the taxpayer or <br />Uayl. -Vi :•L'i ice'• /:IIH;&IW'Fl <br />N�II <br />k33 PM <br />200202559 <br />us:acansc. aciju .w. <br />Nebraska Idontaratron Number TU.. Fled Wdh <br />7941099 Rogow of Deeds ❑CwmyClark <br />Soeiel 6eduity or Federal I.D. Number <br />593 -70 -7172 <br />9poune'n Social SaCUdty Number <br />Lien Serial Number <br />02/D3/307 <br />Lan Type <br />(3origirial ❑COMinwbon ❑Co aced <br />Date al Uen <br />03 -OS -03 <br />Count <br />HALL <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business rnme <br />NOVEDADES & CDNCENTTDA <br />Name <br />OFELIA SANCHEZ <br />Street Address <br />210 W 4TH <br />Street or Other Mating Address <br />210 W 4TH ST <br />Cry State Tip Cade <br />GRAND ISLAND NE 68801 <br />City State Zip Code <br />GRAND ISLAND NE 68801 <br />Tea <br />Category <br />lax Paldxi <br />Assessment <br />Amount of Ter: <br />Penally <br />intarrlst <br />Addltlons <br />sakttes of <br />Asessameril Due <br />04 -01 -01 — <br />_ 1 <br />Q2—Q7—Q2 <br />901 <br />29.43 <br />1021.44 <br />Please stud to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2�0 ST STE 460 <br />GRAND ISLAND NE 68803 <br />. <br />TOTAL <br />$ 1021.44 <br />I hereby ce" that the Nebraska Department of Revenue has cempliad with the revorwe laws of the State of Nebrd3k2 in the ddaennnaecn <br />oftheemountshownbbetl , andtMtynpaV orhasfailedtopaythearno duealterdemand.Ifthis Notdeof State Tea Uenaeneztensco of <br />anatlecllva Gen, kaervestoe Ironuethepnmityofinestate'S inferas t the affected lxopeny the taxpeya. _ <br />r <br />Sign <br />here p ei•a Signature <br />Date TelephoneN <br />LJN�rlalai� <br />Auttwnzed na TKIe <br />NEBRASKA DEPARTMENT OF REVENU • Wt.ite and Goldenrod Copies TAXPAYER - Pink Copy 00 IB Car COPY <br />6" -� `."nd� F s_es <br />