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12/22/2006 17:24 FAX 14024714429 NEBRASKA Dee tal 003/004 ~ \)~ 200611361 9906486346-7 PSIS: 1 KREJCI MARVlN J Filed: 1212212006 10:55 AM Please Return Original Copy to the Nebraska Dept. of Revenue at 200 South Silber, North Platte, NE 69101 IIr Notice of State Tax Lien, nebr.!l$kll department . . of rivenIJ8 PLEASE DO NOT WRITE IN THIS SPACE INDIVIDUAL INCOME TAX soc. SEC. NO. NEBR.- IDENT. NO. SPOUSE SOC. SEC. TAXABLE YEAR LIEN NO. COUNTY DATE OF NOTICE DATE OF ASSESSMENT 508948413 . 35417293 NO. 506844436 20'03 062511520 HALL 09/08/2006 06/22/2006 MARVIN J & TERRI L KREJCI 2718 W 1ST ST GRAND ISLAND NE 68803 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 THE COUNTY FOR PROPERTY BELONGING TO THE TAXPAY.ER OR HEREAFTER ACQUIRED. AMOUNT OF TAX. . . . . . . . . 194.00 PENALTY -. . . . . . . . . . . . . . . 9.70 - INTEREST (COMPUTED TO 09/08/2006) . . . . 27.93 TOTAL AMOUNT DUE . . . . . . . . . 231.63 , I HEREBY ,CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED, WITH THE REVENUE LAWS OF THE STATE OF NEBRASKA IN THE 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 CONTINUE THE PRIORITY OF THE STATE'S INTEREST IN THE AFFECTED PROPERTY OF THE TAXPAYER. TURE , YaVftlU!-t-.-. ~ . . " . . TIT~ ' - . . . . . . . . . .-;:. . . . . . . . . . . . . TITLE . . . . . . . /ti'ot As:-!j-g if DATE/TELEPHONE . . . ./~:-./7.-.o.~_ . -. . . DATE =.!j