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06/06/2008 FRI 14:49 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall 121003/003 ()~ Please forward to: Nebraska Dept of Revenue 4500 Ave I PO Box 1500 Scottsbluff, NE 69363-1500 200804922 \1111\11""1 9908562232-3 E '" Pll. GUERRA ESCOBAR JOS ~ F'l d' 06/06/200802,12 PM 1 1II . . IIr Notice of s~te Tax Lien nebraska department of rwenlJe PLEASE 00 NOT WRITE IN THIS SPACE soc. SEC. NO. NEBR. IDENT. NO. SPOUSE SOC. SEC. NO. TAXABLE YEAR LIEN NO. COUNTY DATE OF NOTICE DATE OF ASSESSMENT INDIVIDUAL INCOME TAX 506439026 43241026 2005 072010200 HALL 07/20/2007 05/01/2007 JOSE R GUERRA ESCOBAR 1021 W 11TH ST .GRAND ISLAND NE 68801 THIS NOTICE OF STATE TAX LIEN IS ISSUED BY THE NEBRASKA,. DEPARTMENT OF REVENUE FOR INDIVIDUAL INCOME TAX PURSUANT TO THE REVENUE LAWS OF THE STATE OF NEBRASKA. NOTICE IS HEREBY GIVEN THAT INDIVIDUAL INCOME TAXES INCLUDING PENALTIES AND INTEREST, WHICH ARE SHOWN BELOW ARE DUE FROM THE TAXPAYER SPECIFIED ABOVE AND REMAIN UNPAID .AFTER DEMAND. THESE TA~ES CONSTITUTE A LIEN IN THE COUNTY FOR PROPERTY BELONGING TO THE TAXPAYER: OR HEREAFTER ACQUIRED. _ AMOUNT OF T_AX . '. . . . . . . . . . . 200.00 PENALTY .' . . . . . '.' . . .' . '. . . 10.00 INTEREST (COMPUTED TO 07/20/2007) . . 17.36 UNDERPAYMENT OF ESTIMATED TAX PENALTY. 0.00 TOTAL AMOUNT DUE . . . . . . . . . .. .. 227.36 I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED WITH THE REVENUE LAWS OF THE STATE OF NEBRASKA IN THE 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 TAX LIEN IS AN EXTE ION OF AN EFFECTIVE LIEN IT SERVES TO CONTINUE THE PRIORITY OF THE TATE~IS I~TEREST IN THE A}FECTED PROPERTY OF THE TAXPAYER. . ~...~ ..~..a4..... 'kl4l../~df1JJ.-J1QQ ~ R' GTE TI1Jjl ~- '. DATE/TELEPHONE ~IZED SIGNATURE T~~' . . . . . ~ . . . Zpr. - - - . . f 11115 10104