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. 02/01/~006 15:53 FAX 140~4714429 ~ NEBRASKA Dee u' 200600910 IIr NOTlCE-<lE STATE TAX LIEN ~~3~~~ . ii"l>r.v;~ rd'p;lrltnOlll q~ r~;~i1n.9 ~006 , PLEASE DO NOT WRITE IN THIS SPACE This Notice of State Tax Lien is issued by the Nebraska Department of. Revenue for unpaid taxes pursuant to the revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are shown below, are due from the taxpayer specified below and remain unpaid after demand. These taxes constitute a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. Nebraska Identification Number Federal Identification Number 34038876 Lien Serial Number Lien Filed With Social Security Number Spouse's Social Security Number 970800037 1KI Register of Deeds o County Clerk 56347-7402 Dafe of Lien Lien Type County 07/01/1997 o Original [R] Continuation o Corrected HALL r BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS .1 Business Name Name ALVINA CORTEZ Street Address Street or Other Mailing Address 7320 W 64TH STREET City State Zip Code City State Zip Code PRAIRIE VILLAGE KS 66202 I Tax 1 Category Tax Period Date of Amount of Tax Penalty Interest Additions Balance of Number Assessment Assessment Due 22 1992 02/04/1997 516.00 25.80 178.02 719.82 TOTAL $ 719.82 I hereby certify that the Nebraska Department of Revenue has compiled 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 dU'e after demand. If this Notice of State Tax Uen is an e nsion of an ective lien, it serves to continue the priority of the state's interest in the affected property of the taxpayer. 402 471-5928 sign ... here .... REVENUE SENIOR AGENT Title REVENUE AGENT Title I-Jl-iJv Date' Telephone Number )~2b-O?- bate 4-494-1974 Rev. 2-2002 Supersedes 4-494-1974 Rev. 10-1995 ~