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<br />05/10/2006 13:29 FAX 14024714429 <br /> <br />NEBRASKA Dee <br /> <br />141 009 <br /> <br />~~ <br />\J <br /> <br />NE !On of !Otot. Juh" " G.lo . uce STL <br /> <br /> <br />200604146, <br /> <br />9911164152343-1 pgs: 1 <br />PRRRR GERRRDO <br />Flled; 05/08/2006 01 ;30 PM <br />Please Return Original Copy to the <br />Nebraska Dept. of Revenue at 200 <br />South Silber,-North Platte, NE <br />69101 <br /> <br />Ir <br />lW~~k. <br />\IOH__nt <br />,~t.,~ijI(. <br /> <br /> <br />NOTICE OF STATE TAX LIEN <br /> <br />This Notice of State Tax Lien is issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to 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 and 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 aCQuired. ' <br />Nebraska Identification Number <br /> <br />PLEASE DO NOT WRITE IN THIS SPACE <br /> <br />Federal Identification Number <br /> <br />99337983 <br /> <br />Lien Serial Number Lien Filed With <br />52?,402i.. ,~, 00 Register of Deeds 0 County Clerk <br />'--,-, Lien Type <br />05/04/2006 - ~ Original 0 Continuation <br />BUSINESS NAME AND LOCATION ADDRESS <br /> <br />Social Security Number, <br />464-71-0324 <br /> <br />CountY_\;. :", <br />HALL <br /> <br />Spouse's Social Security Number <br />453-13-6263 <br /> <br />Date of Liel1 <br /> <br />D Co~rected <br /> <br />r <br /> <br />TAXPAYER t'lAME AND MAILING ADDRESS <br /> <br />I <br /> <br />Business Name <br /> <br />Name <br />GERARDO & DELIA M, PARRA <br />Street or Other Mailing Address <br />619 ROUSH LANE <br /> <br />Street Address <br /> <br />City <br /> <br />State <br /> <br />Zip Code <br /> <br />City <br /> <br />22 <br /> <br />2002 <br /> <br />06/16/2005 <br /> <br />345.41 <br /> <br />28.02 <br /> <br />99.07 <br /> <br />State Zip Code <br />NE 68801 <br />Additions Balance of I <br /> As$essment Due <br /> 472.50 <br /> <br />GRAND ISLAND <br /> <br />I Tax <br />Category <br />- Number <br /> <br />Tax Period <br /> <br />Date of <br />- Assessment <br /> <br />Amount of Tax <br /> <br />Penalty <br /> <br />Interest <br /> <br />TOTAL <br /> <br />$ <br /> <br />472.50 <br /> <br />I hereby certify that the Nebrask'a Department of Revenue has complied with the revenue laws of the_ _State of Nebraska in the <br />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 <br />Tax Lien - an extension of an,effective lien, It serves to continue the priority of the state's interest in the affected property of the taxpayer. <br /> <br />. 308 535..:8294 <br /> <br /> <br />Revenue Agent <br />Tille <br />Revenue Supervisor <br />Tille <br /> <br />5- Lf-Or; <br /> <br />Date <br /> <br />sign <br />here ... <br /> <br />. - Telephone Number---- <br />, 6-.....-;.".tp . <br />Dale .(')~ <br />4-<194-1974 Rev. 2.2002 Supers~des 4-494.1974 Rev. 10-199,5' --X 1) <br />