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<br />03/05/2007 MON 17:09 FAX 402 471 2530 secofstate/licensing div
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<br />~ 004/008
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<br />200:70 1 ~ 99
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<br />99074911613-0
<br />SANCHEZ GUADALUPE J
<br />Fil~d: 0~'0~'2001 j0:4~ AM
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<br />'Plea.se Retunl Original Copy to the
<br />Nebraska Dept. of Revenue al200
<br />South Silber, Norl.h Platte, NE
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<br />69101
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<br />If
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<br />,N'OTICE OF STATE TAX liEN
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<br />\., PLEASE DO NOT WRITE IN THIS SPACE
<br />This Notice of State Tax Lien is issued by the Nebraska Department of
<br />Revenue tor unpaid ta.x,es pursl,IIantto the revenue laws of lhe state of
<br />Nebraska. Notice is hereby given that taxes including penalties and
<br />interest. which are shown below. are due from the taxp.ayer specified
<br />below and remain unpaid after demand. These taxes constitute a lien
<br />inthe county for real and PQrsonal property belonging to the taxpayer
<br />or hereafter ae uired~ ''', . I"", :.,' ,.. ",.
<br />Nebraska Identification Number F:ederalldentification Number
<br />36738824
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<br />
<br />Spouse'$ Social'Security.Number
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<br />Lien Serial Numbl,lr Lien Filed With "
<br />9722.!0316,~', IZJ Regiller of Deeds 0 COunty Cletk
<br />DllIWQfl.IIiI". ..."...,""" ,.'LiftnTYPM','":,,'..',,
<br />, ;,08/15/1.997L' , , [] Original ~'cqnli~u~i~n
<br />BUSINESS NAME AND LOCATION ADDRESS
<br />Business Name
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<br />"CouiiIV,:. ",.''.
<br />, DCorrected '., . : HALL., '.,,' ',I .'
<br />TAXPAYER NAME AND MAILING ADDRESS
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<br />Name
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<br />GUADALUPE J SANCHEZ
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<br />Slre",l Addte,,. Str<!:lI:l or ::l!hMr Malline Addrll,.,.
<br /> PO 80X 343
<br />City Slale.' . Zip Code Cily Slale Zip Code
<br /> "
<br /> GRAND ISLAND' NE 68802
<br />I Ta~ ,I
<br />Category "filX Period, DlIte of . . Arnoll'nt ,of. lalC , Penalty Interest Additions BalaMe of
<br />Number Asaessment Asseallmnnt Dun
<br />22 '1993 07101/1997 2,76.(>9 ..' 13.80 78.95 368,75
<br /> '," 1':.,1. . ' . I
<br /> . . .
<br /> U Ct ~ ( 6Sq'llo~t.."3'l 'I .
<br /> ~() f4r .
<br /> q 7-ID g l3;; c..
<br /> '. TOTAL $ 368.75
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<br />sign
<br />here ....
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<br />I herebycertifythatlhe ,Nebraska Department Df Revenue has complied with Ihe rev~lOuelaws. of the State of Nebraska in the
<br />delermination of llle llmount':;howntoJie !lue. and the taxpayer hall failed to pay the amount due, lifter demand. If this Notice of Stale
<br />Tax. Lien i . exte~5io~ lIneff tiviJ'lie; it8a:V1l5 to' continue ttie priority of the state',s int~ . 'in the affected property of the taxpayer.
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<br />... ) z.~ ."'--" Revenue A~ent . ' .. 308 535-8294
<br />arel's signature [Jill",', TfIIli<ophMfII Number
<br />~R~nue Supervisor ?-~. 07
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<br />~-4~4-,~r4 !lev, 2.2002 Supers,do. 4,4i4,jQ74 Rov. lG-1995\.x
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