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11/13/2006 17:14 FAX 14024714429 NEBRASKA Dee ~ 0021003 <c. ~ '" " 5T\.. r, 200610167 Please Return Original Copy to the Nebraska Dept. of Revenue at 200 South Silber, North Platte, NE 69101 IIr Notice of State Tax Lien nebraska ' cIlIporortmenl of revtlnUI PLEASE DO NOT wRITE IN THIS SPACE soc. SEC. ,NO. NEBR. IDENT. NO. SPOUSE Sac. ,SEe. NO. TAXABLE YEAR' 'LIEN NO. COUNTY DATE OF NOTICE DATE OF ASSESSMENT INDIVIDUAL INCOME TAX 345581857 , 99132753 .. 2003 061250030 HALL 05/05/2006 03/16/2006 JOSE CONTRERAS 319,5 WALNUT, ST APT 314 GRAND ISLAND NE 68801 ", THIS NOTICE OF Sl'ATE'TAx LIEN IS ISSUED BY THE NEBRASKA DEPARTMENT OF,' REVENUE FOR INDIVIDUAL INCOME TAX PURSUANT TO, THE REVENUE LAWS OF THE STATE OF NEBRASKA., ,NOTICE ,IS HEREBY GIVEN ~T INDIVIDUAL .INCOME TAXES INCLUDING PENALTIES AND INTEREST I WHICH ARE SHOWN BELOW ARE DUE FROM THE TAXPAYER SPECIFIED ABOVE AND REMAIN UNPAID AFTER DEMAND. THESE TAXES 'CONSTITUTE ,A ,LIEN IN THE COUNTY FOR PROPERTY BELONGING TO THE TAXPAYE~ OR HEREAFTER ACQUIRED. AMOUNT OF TAX . . . . . . . '. . . . . .'. A . .. 257.00 PENALTY . .' '. . . . . . . . . . . . . . . . . .. 12. 85 INTEREST (COMPUTED TO 05/05/2006) 31.68 TOTAL AMOUNT DUE . . . . . . . . . . . . . . .. 301.53 I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMENT OF ~VENUE HAS COMPLIED WITH THE REVENUE LAWS OF THE STATE OF NEBRASKA IN THE DETERMINATION OF' THE AMOUNT SHOWN TO, BE DUE, ANi> THE TAXPAYER HAS FAILED TO PAY THE AMOUNT DUE AFTER DEMAND. IF THIS NOTICE OF ST~TE TAX LIEN IS AN EXTENSION OF AN EFFECTIVE LIEN IT SERVES TO CONTINUE THE,P~IORITY OF , THE STATE I S INTEREST IN THE AFFECTED 'PROPERTY OF THE TAXPAYER. ~Go?~... :UTH~ ~ .a~... .. . /!-.2.-{Jf.. .;(;t}M..f21!- ~~~ . . . . . . . . . . . . . .H~~~~. .... TITLE DATE,. , . ""~ Ims'~