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<br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska In the <br />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 <br />Tax Uen 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 />· REVENUE AGENT \~lq~ 402471-5928 <br />sign ... Title Date Telephone Number <br /> <br />here ... REVENUE SENIOR AGENT /-7 -/9-/) 9 <br />Title Date ~ <br />4-494.1974 Rev. 2-2002 Supersedes 4-494.1914 Rev. 10- \~ ...-' <br /> <br />12/27/2007 THU 14:54 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />& <br /> <br />200710725 <br /> <br />111111111" <br /> <br /> <br /> <br />9907539797..8 PSI'. 1 <br />MARTINEZ RAV R Al'I <br />Filed: 12127/2007 09:15. <br /> <br />If" <br /> <br /> <br />NOTICE OF STATE TAX LIEN <br /> <br />lldltfl.fG <br />dopellmonl <br />Oft~ <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 pursuan~ 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 acquired. <br />Nebraska Identification Number Federal Identification Number <br /> 41116720 <br />Lien Serial Number Lien Filed With Social Security Number Spouse's Social Security Number <br /> 120070360 ~ Register of Deeds D County Clerk 458-65-6375 <br />Date of Lien. Lien Type County <br /> 12/19/2007 ~ Original 0 Continuation o Corrected HALL <br />I BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS I <br />Business Name Name . . <br /> RAY R MARTINEZ <br />Street Address Street or Other Mailing Address <br /> 429 STALLION LN <br />City State Zip Code City State Zip Code <br /> GRAND PRAIRIE TX 75050 <br />J Tax I <br />Category Tax Period Date of Amount of Tax Penalty Interest Additions Balance of <br />Number Assessment Assessment Due <br />22 2003 05/09/2007 349.00 17.45 19.66 386.11 <br /> TOTAL $ 386.11 <br /> <br /> <br /> <br />~002/009 <br />