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<br />& <br /> <br /> <br />P.2/2 <br /> <br /> <br />--H,glrlfllr <br /> <br />990&487546-0 P9S, 1 <br />~OLrKOWSK! D~rEL J ' <br />~iled; 12/29/2006 04:25 p~ <br /> <br />DEe 29 '06 05:58PM <br /> <br />200700007 <br /> <br />IIr <br /> <br /> <br />Please Return Original Copy to the <br />Nebraska Dept of Revenue at 200 <br />South Silber, North Platte, NE <br />69101 <br /> <br />NOTICE OF STATE TAX LIEN <br /> <br />II~ra;", <br />dtpartnulll <br />of r.....Wlllt <br /> <br /> , PLfASe 00 NOT WRITE IN THIS SPAC& <br /> I <br />This Notice of state Tax Lien i. ,..ued by thlNeb....ka Department of <br />Revenue for unpaid taxes pursuant to the te t1L1e laws of the state of <br />Nebraska. Notice is hereby given that taxes i 'eluding penalties and <br />interest, which are shown below, are due fro the taxpayer specified' <br />below and remain unpaid' afte!' demand. Tlte: taxes constitute a lien <br />in the county fa!' real and personal property longing to the taxpayer <br />or hereafter acauired. ' , <br />Nebraska Identification Number ) Federalldentifil;iltion Number <br /> 36416263 ,I <br /> ... .. <br />Lien Serial Number l,.ien F=lIed Willi SOl;llal $$Qurity Number Spouse's Social Securlty Number. <br /> 9704~012B ~ Register of ~eedll D.county Clerk 505-80-2136 <br />Dale of Lien Lie.~ Type County . , <br /> 02/1411997 o Original ~ Contl"ualion D Corrected HALL <br />I BLlSINESS NAME AND LOCATION ADDRESS.! TAXPAVER NAME AND MAILING ADDRESS I <br />Business Name , Name <br /> '. DANIEL J. KROLIKOWSKI <br /> i <br />Street Address >. Str~et or Olher Mailing Address <br /> , PO BOX ,549 <br /> , <br />Cily Stale ~ Code City Slate Zip Code <br /> WOOD RIVER NE 6S883 <br />~ Tax . I <br />Cat9gory Tax Period Date of AmOU~ of Tax Pemllty Int9rest Additions Balance of <br />lIIul'tlbar Assessment Assessment Due <br />22 19~3 12/26/1996 76~OO 191.75 185.01 1,143.76 <br /> : <br /> , <br /> t <br /> iNf.4b . <br /> n~q11b21S5 ! <br /> ,,~:~ '11-I024~" \ <br /> J <br /> '. TOTAL $ 1,143,76 <br />I hereby certify that the Nebraska Department of Re1l nUlill1aG complied with the revenue laws of tile Slate or Nebraska in the <br />determinliltion of the amount shown to be due. and till taxpayer has flliled to pay the amount due after delTlilnd. If this 'Notice of State <br />Tax l.ien" an .extQnsion of an..].ffeclive lien, it serves 0 conlinue Ihe priorily of Ihe stale's interest in the affel;lted property of the talCpayer. <br /> <br />sign .,. <br />here .. <br /> <br /> <br />tRevenue Agent <br />~Tille <br />'Revenue Supervisor <br />Title <br /> <br />l;)~).t- tJ6 <br />Date <br /> <br />308 535-8294 <br /> <br />telephone Number <br />/,dJ-.;? ?-"-' b <br />Oate ~ <br />~-49~-197~ Raw. 2-2002 Suplnlldn ~..4e4-197A Ray. 10-1995 rt').-l <br />