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<br />08/08/2006 16:08 FAX 14024714429
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<br />NEBRASKA Dee
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<br />~ 002/002
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<br />Please return to:
<br />STA TE OF NEBRASKA
<br />DEPARTMENT OF REVENUE
<br />1811 WEST 2ND ST STE 460
<br />GRAND ISLAND NE 68803
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<br />200607079
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<br />~.lln-1 '"
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<br />99115414814-3 Pus: 1
<br />I'ICNAIR RHONOR J
<br />Fil.d: 0810812006 09:56 AM
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<br />I
<br />i
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<br />If
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<br />NOTICE 'OF STATE TAX LIEN
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<br />, ....
<br />dtNn."..'
<br />01..........
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<br /> PLEASE DO NOT WRITE IN THIS SPACE
<br />This Notice of State Tax Lien Is issu'ad by.tlle Nebraska Departrrient of
<br />Revenue for unpaid taxes pursuant to the revenue law$ 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 Numper Federal Identification Number
<br /> 7965067 " '-, r " ' , , ~ ~ \ .-
<br />Lien Seriai'Number Lien Flied With ' ' .' S~cial SeciJrity Number ~,: '. ~ ~~o~s.e's Social Security Number
<br />, - -- :'ri~IK,~/r\n:l:i- .'1- - , . J,. " _ ..'. I I ' . ~._ trcoJn~ Clett< .1.::'
<br /> ~ 'R~ister of De&ds - - , 507 ~76;'81 07 . ~. '. . , .. .. .- . I'~
<br />Date,Df Lien ", Lien- Type -... - .. County_", , - - --
<br /> 07/2212006 ' o Origil1al D Continuation o Corrected 'Hall
<br />I BUSINESS NAME AND LOCATION ADDRESS TAXPAYER 'NAME AND MAILING ADDRESS I
<br />Business Name Name'
<br /> Rhondei J McNair
<br />Street Address Street or Other Mailing Address ,
<br /> 701 WestState Street'
<br />City State Zip Code City State Zip Code
<br /> Grand Island NE 66601
<br />I Tax I
<br />Category Tax Period Date of Amount of Tax Penalty Interest Additions Balance of
<br />Number Assessment Assessment 'Due
<br /> 01 01/01/2003- 12/03/2004 55.84 69.92 26,37 0.00 152.13
<br /> 12/31/2003
<br /> 01 01/01/2004- 07/2212006 156.44 40.84 14.14 213.42
<br /> 09/30/2004
<br /> 01 1 % 1/2004- 07/22/2006 58.01 5.80 5.18 66.99
<br /> 12/31/2004
<br /> 01 01/01/2005- 07/22/2006 ' 238.87 46.89 6.99 294.75
<br /> ,12/31/2005
<br /> ., - '" ,-' ." ~. ,~. r." '" ' --
<br /> - , -, ' 0'-' - ,-
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<br />- - - , - , ,.. -.~. , .. .. ".-, " TOTAL' . ,,"", ..' $ 729.29 - - ,
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<br /> ,- .-: -.-, ,-, .. ,-
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<br />, I hereby certify that the Nebraska Department of ,Revenue has -complied with the revenue Jaws of the'State of Nebraska in the _
<br />. _ " - determination of the amount shown to be due, 'andltle ta,xpay~r has failed to pay the amou~l due after demand. If !his Notice ,0f,State
<br />Tax Lien is,an "emilon of a effectiv~ lien, it serves to continue the priority of the state's Interest In the affected'property of the taxpayer.
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<br />308 385-6074
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<br />Revenue Senior Agent
<br />Title
<br />Revenue Supervisor
<br />Title
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<br />07/31/2006
<br />Date
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<br />sign ...
<br />here
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<br />Telephone Number
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<br />07/31/2006
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<br />Date rf\
<br />, ~-'l94-197~ Rev. 2-2002, 9u.,.nede$ 4-494-197~ R..v_ 10-111% \V
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