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NEBRASKA Dee Igj 003/003 11/17/2006 17:54 FAX 14024714429 'Oro IIr nebraska dl!partment of n'Vl!nLlll! r.~ "~~ 200610319 9818488946-3 Pas. 1 WESCOAT DAVID G . Fil~: 11"7/2DB8 04:05 PM Please Return Original Copy to the Nebra~lqt. Dept. of Revenue at 200 South Silber, North Platte NE 69101 ' Notice 'of state Tax Lien PL.EASE DO NOT WRITE IN THIS SPACE INDIVIDUAL INCOME TAX SOC. SEC. NO. NEBR. IDENT. NO. SPOUSE soc. -SEC. NO. TAXABLE YEAR LIEN NO. COUNTY, DATE OF NOTICE DATE OF ASSESSMENT 507827406 21036993 2003 061040062 HALL 04/14/2006 0-2/14/2006 DAVID G ,WESCOAT 10'2 W PINE PO BOX 42 ALDA -NE 68810 THIS NOTICE OF STATE 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 THAT INDIVIDUAL INCOME TAXES INCLUDING PENALTIES AND INTEREST, WHICH ARE SHOWN BELOW ARE DUE FROM THE TAXPAYER SPECIFIED ABOVE AND REMAIN UNPAID AFTER DEMAND. THESE TAXES CONSTITUTE A-LIEN IN ~HE COUNTY FOR PROPERTY BELONGING TO THE TAXPAYER OR HEREAFTER ACQUIRED. AMOUNT OF TAX . . . . . . . . . . . . . . . - 4,116.84 PENALTY . . . . . . . .' . . __". . . . . . ~ 221.29 INT~REST (COMPUTED TO 04/14/2006) 527.94 , TOTAL AMOUNT DUE . . . . . . . . 4,866.07 I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED WITH THE REVENUE LAWS OF THE STATE OF NEBRASKA IN TaE 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 TAX LIEN IS AN EXTENSION OF AN EFFECTIVE LIEN IT SERVES TO tONTINUE THE PRIORITY OF THE STATE'S INTEREST IN THE AFFECTED PROPERTY OF THE TAXPAYER. .1kt.U~. . ERIS SIGNA ~~....... . ~..()/{';~': . . . . . . . . . . . . TITLE IljH:-/)~/ r;~ks.~2q tf DATE/TELEPHONE . ~ /I--I.{q-.:()~ . . . . . . . DATE ...... .:.. ---~