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<br />NEBRASKA Dee
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<br />14I 005/007
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<br />04/19/2006 08:38 FAX 14024714429
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<br />, . PLEASE DO NOT WRITE IN THIS SPACE
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<br />~:....._ ~ :.ltice of Stite'Tlix Ueills':li;sued. by,~~~~Neb.::as~ D~pa~ent 0[... ,.,' ,I: '~.::.:E7:~~_;:.:'.::' ' .,,,,-- ',-"
<br />Revenue for unpaid taxes pursuant to the' revellue laws of the state of
<br />Nebraska. Notice is hereby giveil thlll taxes' includiug penalUes. and
<br />interest, which are shown below, are'due from the taxpayer specified
<br />below and remain unpaid aftir demand. These taxes constitute a lien in
<br />the county for real and perso~al proper:tY b~onglng to the taxpayer or
<br />hereafkracquired, , '.,'
<br />NebraskBldentifica1ion Number Wen Rted Witt; Social Security or Federal 1.0. NllflIber
<br />'J 2 5 005 1 IX) , Register of Deeds 0 County Clerk ? 3 1 3 3 9 05 0
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<br />Lien Sertal Number Uen Type . , . . I Date of Uen CoUflty
<br />7/0.1/344 ~Original DContinuallon DCmrected I 01-28.-137 HALL
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<br />I BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAlUNG ADDRESS,,'
<br />Business Namo '. NamB..: ...T
<br />()r)..~ tmo,VB 'INN' .'" " TE~K Cae? ' .<'~'
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<br />Street Addl"e$S " , ; . ,'__....c.., ..lilllc!e1,9r,Qll!Br MaltIng AddrEIIS ' ..'
<br />.3 205 S LOCD$T" ..~r..."""!,,,,:-:--"::i:'" >q S.7' . ':~":''e:l",,~;rI. ::::''1'~ ., '.L'~O ' .,
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<br />City stalll, .,...... " , Zip COdB, City , - .,~" " ,
<br />\3:1.e;,NfJ ISLPSD N"E" 88302 TULSA Oft: '''-I
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<br />I herebY cei-ilfy lhit Ihll Nlltxaaka 06partrnent 'of RaYenue has complied with ihe rEll/llnUB laws of the State of Nebraski'i'h 1he cillterlilirlation ,,' ,...:,:
<br />of lhe,amount shoWn to be dUB, iwl the taxjlayer hU failed 10 pay the am9Unt dUll after d8mand. .. If this Notiee of $la\e Tax Lien Is an wctanslon'i:JI. . '..
<br />an effectiVe lien. \tlWtveS to' eontinl;lB the prioIity.g{ the suite's Int8fBrt i'nlhe aff8Cteil Property of the taXPay..' ." ,;'. " " f
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<br />here ..P\1Iflarer's Signature ~:->,. . ~ . :_ 'C :. - Date
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<br />.< NEBRASKA DEPARTMENT OF REVENUE - While and Goldenrod CopieS
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<br />Notice of State Tax Lien
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<br />Spouse's 5ol::laI Security Number
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<br />, TlIX Period
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<br />Date of AmountofTu Penalty Inter_ Addition. ,
<br />Assessment
<br />02...20-97 1,a14~20 1 B 1 .-4 2 ,93065 5..00
<br />10-07';"95. ,0..00' --as .34. ,. -, ~n,. a4 , . '.
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<br />Zip COde
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<br />Balance of I
<br />Assessment Due .
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<br />07-'l\1-9b -
<br />07-31-95
<br />u1:'-Ul-96 -
<br />68-30-'95
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<br />09-30-95 02-07-91 1,343.74.
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<br />lQ~31-95 02-07-97 1,250.52
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<br />07-31-96 02-20-97967.29
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<br />2,084.27
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<br />134.37
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<br />'tlllephone No.
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<br />TAXPAYER - Pink Copy
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<br />...5 ,.l.,j: ",~'~, ~
<br />Dale .,
<br />COUNTY OFFICE - Canary Copy
<br />4-494-74 _. 1G-1l& ~ +G4-14 Aev. &-85
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