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12/08/2006 16:52 FAX 14024714429 NEBRASKA Dee ~ 0021002 200610915 nr rllllllll','1 9906484192-8 PllS' 1 REDWINE SHANE Fll.d: 1}!~_9~.2~~6 ~_:_~7~__,_--:- _. Please Return Original Copy to the Nebraska Dept. of Revenue at 200 South Silber, North Platte, NE 69101 I I I ~ Ir NOTICE OF STATE TAX LIEN ~"b , ~"'I'IMM tj(~- PLEASE DO NOT WRITE IN THIS SPACE This Notice ~f State Tax Lien is issued by the Nebraska Department of Reveriue'for-unpaid taxes ,pursuant to the revenue laws of the.state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are shown below, are due from the taxpayer specified below and remain unpaid after "demand. These taxes constitute a lien in the counW for real and personal property belonging to the taxpayer or hereafter aCQuired. , NibraSka IdElntlfication Number Federalldenlificatlon Number ". '." 29491983 . - ., """ Lien Serial Number Lien Filed With Social Security Number Spouse's Social Security Number I " '51330039 - ~Rt;lgiste,~_cif ~.e.cls, o County Cle'rk 506';:94-0765 " .. ' 505-02-3016 ' , , . , " ' . 0- r",..' . '. '. '. pate of Lien , ' " " LienType' .:'.", --,-, ' . County,':r' ,:.. " , . __I 'f "'I ' -" .--- I!] O~gi~al 0 '6~niin~ation o Co~ected .. ,.r '-' ,_ _. " ' ' - "' 12/06/2006 HALL, - . r I BUSINESS NAME AND U)CATION ADDRESS' TAXPAYER NAME AND MAILING ADDRESS . I Business I Name Name i SHANE & TERESA REDWINE s~reet Ad ~ress Street or Other Mailing Address i 4152 HARTFORD ST 9ity State Zip Code City State Zip Code GRAND ISLAND NE 68803 II. Tax I ~atego 'Y Tax Period Date of ' Amount of Tax Penalty Interest Additions Balance of NumbEr Assessment Assessment Due I 22 2002 02/1512005 1,720.00 727.50 528.04 2,975.54 I i I i I i -,I , . , . TOTAL $ 2,975.54 , - :'1' ., I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of. the State of Nebraska in the , determination of t~frambuiit shown to b,e due, and the taxpayer has failed to pay the amount'due after demand. If this Notice of State Tax Lien' an extension of an e#Qctive lien, it serves fa continue the priority of the state's interest 'in the affected property of the 'taxpayer.. ~::. -:.. ',' .. Revenue Agent /.;).:-t, ;...CJ 6. ,,:.' 308 535-8294 ',~' ~Ign Title Date Telephone Number ~ere, ~ Revenue Supervisor Idl..t,-()t; , I gnature Title Date I 4-49~-1974 Rov. 2-2002 Suporsedo. 4-494-19H Rev. 1G-1995 Q\)