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0210112006 15_: 55 FAX 14024714429 NEBRASKA Dee ~010 vt "I s." .f Ib~. J."" ~ G.I.. - uee STL 200600914 9908434996-2 JUETT DOUGL.RS H Fil,d, 01/26/2006 12:47 PM IIr NOTICE OF STATE TAX LIEN n.;.br~~ d4~tcl1 1)1 <(!1o'onllV 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 personai property belonging to the taxpayer or hereafter acquired. Nebraska Identification Number Federal Identification Number 23282436 Lien Serial Number Lien FiledWith Social Security Number Spouse's Social Security Number 42680085 [RJ Register of Deeds o County Clerk 505-70-9934 Date of Lien Lien Type County 01/24/2006 IKl Original 0 Continuation D Corrected HALL I BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS I Business Name Name DOUGLAS H JUETT Street Address Street or Other Mailing Address 1018 DELILAH DR City State Zip Code City State Zip Code KINSTON NC 28501 I Tax I Category Tax Period Date of Amount of Tax pen'alty Interest Additions Balance of Number Assessment Assessment Due 22 2003 07/08/2004 209.00 10.45 22.30 241.75 .. TOTAL $ 241.75 I hereby certify that the Nebraska Department of Revenue has complied 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 due after demand. If this Notice of State Tax lien is an >ctension of an effective lien, it serves to continue the priority of the state's interest in the affected property of the taxpayer. l--.1..-L\-o~ 402 471-5928 Date REVENUE SENIOR AGENT Title Date 4-49'1-1974 Rev. 2-2002 supersodes 4-494-1974 Rev. 10-1995 sign ... here ....