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<br />03/15/2006 15:22 FAX 14024714429 <br /> <br />NEBRASKA Dee <br /> <br />I4J 007/007 <br /> <br />200602306 <br /> <br />l\\ll"'\\\\\'" \ <br /> <br /> <br />9906443438-1 '! <br />CHR1SdTEN0~E/N151~~~~10'17 AM <br />FUa: '" <br /> <br />~ <br />D <br /> <br />Please Retum Original Copy to the <br />Nebraska Dept. of Revenue at 200 <br />South Silber, North Platte, NE <br />69101 <br /> <br />ar <br /> <br /> <br />NOTICE OF STATE TAX LIEN <br /> <br />(\1lifI1>>~. <br />;Io"IlI'i'ljl~1 <br />01 ..nilt' <br /> <br /> PLEASE DO NOT WRITE IN THIS SPAC~ <br />This Notice of State Tax Lien is issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant fo 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 arid 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 acauired. ';. <br /> .' <br />Nebraska Identification Number Federalldentifica.\ion Number <br /> " 35930640 ' . <br />Lien Serial Number Lien Filed With Social Security Number Spouse's Social Security Number <br /> '51750088 iZ!Register of Deeds, D CO!JlJty Clerk ,u 507.84-21'65 " - I',' '. <br /> " ' .. <br />Date of Lien ' .. . ,I' . Lien Type " County l! ,~ <br /> [8] Original D Conlinu~lion .. D Co~ecled ' d .,- - ., d. . -- <br /> 03/13/2006 ' HALL ., <br />I BUSINESS NAME AND !-OCATION ADDRESS TAXPAYER NAME AND MAILING ADQRESS ''I' <br />Business Name Name <br /> TERA L. CHRISTENSEN <br />Street Address Street or Other Mailing Address <br /> 940 SPINE <br />City Stale Zip Code City State Zip Code <br /> 0 GRAND ISLAND NE 68801 <br />r Tax I <br />Category Tax Period Date of Amou!'t of Tax Penalty Interest Additions Balance of <br />Number Assessment Assessment Due <br />22 2003 05/10/2005 1,048.00 52.40 '120.08 1,220.48 <br /> . .." <br /> TOTAL $ 1,220.48 <br /> <br />I hereby certify thai the Nebraska Department of Revenue has compiled with the revenue laws of the State of Nebraska in the <br />. determination of Ihe amount shown 10 be due, and the taxpayer has failed 10 pay Ihe amount due after demand. If Ihls Nollce of Stale <br />Tax Lien i n extension 01 an eif!lctive lien, il serves 10 continue the priority of the state's interest in Ihe affec\ed property of the taxpayer, <br /> <br />. =?~/3 ,[J/ 308 535:.8294 . <br />Revenue Agent ~ _ (.9 <br /> <br />Title Date <br /> <br /> <br />sign ... <br />here .... <br /> <br />Revenue Supervisor <br />Title <br /> <br />. Telephone Number <br /> <br />.)-IJ-"~ . Q(\ <br /> <br />Date ! .J <br />~-~9~-'97~ fl..v, 2-2002 Sup~f'$.de. 4-4!l.H97~ Rev. 10-1995 . Y <br />