Laserfiche WebLink
08!09!2002 15:21 FAX 14024714429 <br />rease return to: <br />STATE OF NEBRASKA <br />DEP.&RTN ENTIOFREVENUE <br />1811 WEST 2Y° ST STE 460 <br />GRAND ISLAriD NE 68803 <br />Or <br />n9bgha <br />awnsnent <br />a wranus <br />NEBRASKA UCC <br />200208387 <br />Zoo 2 / 002, <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 penaltles 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 />or hereafter acquired. <br />Nebraska Identification Number <br />Lien Had With <br />Federal Identification Number <br />Social Security Number <br />6349900 <br />QRegister ofDeeds <br />❑County Clark <br />47- 0746741 <br />Lien Serial Numbs, <br />Lien Type <br />Dad of Lien <br />County <br />O� 6 o"Z <br />❑X Original [Continuation L] Corrected <br />08/06/2002 <br />hall <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILINrd ADDRESS <br />Business Name <br />Name <br />Nancy's Cookie Corner, Inc, <br />Street Address <br />Street or Other Mailing Address <br />Conestoga Mall <br />City State Zip Coda <br />City <br />State Zip Code <br />Grand Island <br />NE 68803 <br />Tea <br />-- <br />Category <br />Number <br />Tax Period <br />Date of <br />Amount of Tax <br />Penalty <br />Interest <br />Addition, <br />Balance of <br />As <br />Assessment Due <br />70/0112001- <br />01 <br />01 <br />0 3!31!2002 <br />07!0312002 <br />454.64 <br />25.00 <br />23.90 <br />5.00 <br />508,54 <br />21 <br />07101 112 001 01 <br />12/31!2 <br />0511012002 <br />0.00 <br />34.96 <br />4.88 <br />5.00 <br />44,84 <br />01/2002- <br />21 <br />03/3131 /2002 <br />06!26/2002 <br />352.81 <br />35.28 <br />10.00 <br />5.00 <br />403.09 <br />i <br />TOTAL <br />$ 956.47 <br />I hereby cewfy that the Noomaka Department of Revenue has complied wide the revenue laws of the State of Nebraska In the <br />determination of the amount shown to be due, and the taxpayer has felled to pay the amount due after demand. It this Notice of State <br />fax Lien is aq axl nsien o an of eedve lien, It eervea to oonfinue the priority of the state's Interest in the affected property of the taxpayer. <br />Revenue Senior Agent ,r 308 385 -6073 <br />sign eeparars Signature Title Date Teleph ne berr <br />here a Revenue supervisor 4 <br />J otizilu"turw Title MA f <br />4491 -1974 Ref 2 -2002 Suee36a544e4.1$74 R0� 10199: <br />