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<br />04/23/2008 WED 14:40 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />121002/003 <br /> <br />~ <br /> <br />n ".- <br /> <br />Please forward to: <br />Nebraska Dept of Revenue <br />4500 Ave I PO Box 1500 <br />Scottsbluff, NE 69363-1500 <br /> <br />200803\446 <br /> <br />Imrolll n Illl <br /> <br /> <br />9908557211-2 PIS: 1 <br />VENTURA SUAR JOSE <br />FIled: 04/23/2008 02:37 PM <br /> <br /> <br />..~ <br />Nebraska Department of <br /> <br />REVENUE <br /> <br />ww,"" _ revenue. no _ Dov <br /> <br />Notice of State Tax Lien <br /> <br />PL.EASE DO NOT WRITE IN THIS SPACE <br /> <br />SOC. SEC. NO. <br />. NEBR. IOENT. NO. <br />SPOUSE SOC. SEC. NO. <br />TAXABLE YEAR <br />LIEN NO. <br />COUNTY <br />DATE OF NOTICE <br />DATE OF ASSESSMENT <br /> <br />INDIVIDUAL INCOME TAX <br /> <br />507450557 <br />44228627 <br /> <br />2004 <br />073340073 <br />HALL <br />11/30/2007 <br />09/13/2007 <br /> <br />.JOSE VENTURA SUAR <br />1316 E 5TH ST APT A <br />GRAND ISLAND NE 68801 <br /> <br /> <br />THIS NOTICE OF STATE TAX LIEN IS ISSUED BY THE NEBRASKA DEPARTMENT OF <br />REVENUE FOR INDIVIDUAL'INCOME TAX PURSUANT TO THE REVENUE LAWS OF THE <br />STATE OF NEBRASKA. NOTICE IS HEREBY GIVEN THAT INDIVIDUAL INCOME <br />TAXES INCLUDING PENALTIES AND INTEREST I WHICH ARE SHOWN BELOW ARE DUE <br />FROM THE TAXPAYER SPECIFIED ABOVE AND REMAIN UNPAID AFTER DEMAND. <br />THESE TAXES.CONSTITUTE A LIEN IN THE COUNTY FOR PROPERTY BELONGING TO <br />THE TAXPAYER OR HEREAFTER ACQUIRED. . <br /> <br />...c;;...:.,.:.:.......-...-AMGaN'1':.:...:.0F:.. ....TAX........... ..:... ... ......... ....... .:....:...:. .::.::..:.:.:......:.."......:....... :...... :.'..:. .....:...-.....-;;;..:.:...::;.;.. <br />.-;.......::.:.>c..:.-.: '._. : ".. .:.:...:.._........ .. :...:....:...7-..36::..J,JQ ................ .......... <br />PENALTY . . . '. . . . . . . . . . . '. . 36.80 <br />INTEREST (COMPUTED TO 11/30/2007) . . . . . 129.49 <br />UNDERPAYMENT OF ESTIMATED 'TAX PENALTY . . . . 0.00 <br />TOTAL AMOUNT DUE . . . . . . . . . . . . . . 902.29 <br />I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED <br />WITH THE REVENUE LAWS OF THE STATE OF N~BRASKA IN THE DETERMINATION OF <br />THE AMOUNT SHOWN TO BE DUE, AND THE TAXPAYER HAS FAILED TO PAY THE <br />AMOUNT DUE AFTER DEMAND. IF THIS NOTICE OF STATE TAX LIEN IS AN <br />EXTENSION OF AN EFFECTIVE LIEN IT SERVES TO CONTINUE THE PRIORITY OF <br />TH STATE'S INTEREST IN THE AFFECTED PROPERTY OF THE TAXPAYER. . <br /> <br />. .d:. .~~ ~.C4~~-t........ ~~!(~t./(~~~2:-:/~(jJ <br />RE ,~. ~ ~TURE TI E T;~ DATE/TELEPHONE <br />AUTHORIZED SIGNATURE TITLE ATE <br /> <br /> <br />/lT15 <br /> <br />...... ~ -- ,..--.--.----.--- <br />.-....------ ...- -_......_._-~~~---_.~ <br />