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<br />10/11/2007 THU 15:29 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />1210031003 <br /> <br />\)~ <br /> <br />Please return to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2ND ST STE 460 <br />GRAND ISLAND NE 68803 <br /> <br />20:0708739 <br /> <br />1l1Illlrlln~n <br /> <br />9907529135-4 Pes, 1 <br />JANOVEC LAURIE ~. , <br />Filed: 10/11/2007 09:17 RM <br /> <br />Ir <br /> <br />NOTICE OF STATE TAX LIEN <br /> <br />~mu <br />dtlN"'*" <br />otrt*ut <br /> <br /> PLEASE DO NOT WRITE IN THIS SPACE <br />This Notice of State Tax Lien is Issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice is hereby given that taxes including penalties and <br />interest. which are shown below. are due from the taxpayer specified <br />below and remain unpaid after demand; These taxes constitute a ,lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter acaulred. <br />Nebraska Identification Number .. Federal Identification Number <br /> 9280162 . . ..' . "9'1-1762829 <br /> , " <br />Lien Serial Number ' . Lien' Filed With Social Security Number SpCluse's Social Security Number <br />.. n~\ tJ1l'on4-5 - .. ." - . <br />[!] Register of Deeds o County Clerk _ 505-B2.s270 -.- <br /> ,'" <br />Date of Lien Lien Type "- County "" .. ..-- .. <br />... 10/05/2007 [~::loriginal DContinuation o Corrected Hall <br />I BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDR~SS 1 <br />Business Name Name <br /> Laurie A. Janovec <br />Street Address Street or Other Mailing Address <br /> 7200 South 20th <br />City State Zip Code City State Zip Code <br /> Lincoln NE . 68512 <br />I Tax I <br />Category Tax Period Date of Amount of Tax Penalty Interest Additions Balance of <br />Number Assessment Assessment Due <br />01 , 12/01/2003- 10/03/2006 3,290.60 2,839.97 1,667.45 7,798.02 <br /> 07/30/2006 , <br /> , <br /> .. , ' , . ... <br /> TOTAL $ 7,79B~02 <br /> <br />-, I ~ereby certify thatlhe Nebraska Department of Revenue has complied with the revenue laws of the Stat~ of ,Nebraska!n Jhe '. . ',;, <br />determination of the amount shown to be due, arid the taxpayer has failed to pay the amount due after demand. If this Notice of State <br />-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. <br /> <br />. J. - . Revenue Senior Agent 1())fJ-6'I;U;lJ7 ' 308 385-6073 <br /> <br />sign JI> Prepare(s Signature Tille' Date . Telephone Number <br /> <br />here JI> / Revenue Supervisor /;;1 p'101 <br />utho( Tille Da ' <br />4-494-1974 Rllv. 2-2002 SlIpersedeI4-494-1974 Rev. 10-1995 <br /> <br /> <br />\j--' <br />