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11113/2002 LT:24 FAX 14024714429 <br />NEBRASKA UCC <br />200212562 <br />0004 %OUH <br />111111a� 11111�i�i 11 <br />[Ha zzMwe -4 .: I <br />Gl l.e 11118180311:39 qN <br />�1 NOTICE OF STATE TAX LIEN <br />epoarnelu <br />PLEASE 00 NOT WRITE IN THIS SPACE <br />This Notice of State Tax Lion is issued by the Nebraska Department of <br />Revenue tar unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice Is hereby given that taxes including peneltlee and <br />Interest, which are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These taxes Constitute a Ilan <br />in the county tot reel and personal property belonging to the taxpayer <br />34735747 N%91.terol Deeds LjCdurdyolark 045 -01 -9821 507 -92 -4751 <br />Lien Serial Number Lien Type I Data W Lien County <br />022140450 [X Dnglnal E]COndnmtlon []Comedad 11/20/2002 HALL <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Sushnaw Unn. Name <br />JOSE L & DEBORAH L GREEN CHAVEZ <br />Street Address Street or OMer Nailing Address <br />208 CARDINAL DR <br />City State Zip Code Clly State Zip Cade <br />BRAND III ANf] NF FAR <br />Tax <br />amaary <br />TAX Period <br />Date of <br />Amount of Tex <br />Perolry <br />IntWet <br />AtlCltlane <br />Balance at <br />NT <br />Asses ent <br />Ae tD <br />22 2000. 03/2212002 98.00 99.50 40.21 245.71 — <br />22 2001 05/14/2002 413.00 2065 22.30 455.95 <br />I I I I TOTAL j$ 701.88 <br />1 hereby cedfY Met the Nebraska Department 0 Revenue hat compiled whh the revenue laws of the Stata ei Nebraska h Me <br />deteonmaaen of the amount ¢frown to be due, and the taxpayer has failed b pay the amount due after demand. It this Notice of Stale y . <br />Tex Lien ie gann."Iennd/,o;�p�I an effGotke ilen, it serves b continue the prioriy of the slate'sinterest in the ahrected Dronsi of the tanpayer. fj1` <br />e RJ!! A!•Ati/ �% �Y.%A�.J RBVeRU6 Agent /R ��- 402 471 -5535 <br />sign Pr. r G - Tine Data Telephone rnxar <br />here a Revenue Supervisor <br />AuT drstl Siyxa[ure Tttde Dat <br />'sN esl1 ea,. 211. soner:ene: obey 1alaaev.'c -sce <br />