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<br />08/27/2008 WED 14:30 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall
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<br />121003/004
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<br />Notice of' State Tax Lien
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<br />PLEASE DO NOT WRtTEIN THIS Sp'ACE
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<br />INDIVIDUAL INCOlu;;
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<br />soc. Si::C. NO.
<br />NE5R. IbENT. NO.
<br />S~QUS~SOC. SEt. NO.
<br />TAXAoLEYEAR
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<br />LIEN "'NO.
<br />COUNTY'..",' . ".
<br />DATE OF NqrlcE
<br />DATE Of AS5ESSM~NT
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<br />324605950
<br />30441.-95,3
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<br />19,~3 ..
<br />'990500006 ..' -.
<br />HiII.J.. BRIAN K E:;. ~ B.O'c:'Hi..E
<br />Q.2119/J~,99<':',', '1:325 'WOODMOCR DRIVE
<br />01I05/1$99'" .. MONUMENT' CO 801::12
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<br />...THIS NCJ'TIC,E OF STAlE TAX LIEN 15 ISSUED BY THE NEBRASKA DEPARTMENT OF
<br />.' REVENu2 fOR INDIVIDUAL INCOME TAX PURSUANT TO THE REVENUE LAWS OF THE
<br />, .. SlATE OF jf~BRASKA.' NeTICE 15 HERE8V GIVEN THAT INDIVID.UAL INCOME
<br />-TAXES INCLUDING PENALTIES AND INTEREST, ~HrCH ARE SHOWN BELOW ARE DUE
<br />-FROM THE TAXPAYER SPECIFIED ABOVE AND REMAIN UNPAID AFTER DEMAND.
<br />. THESE. TAXES.,.CONSIl'rUTE A ,LIEN.:,IN lHE COUN-Y. FOR. PRO.PERl't BELONGING JO,.
<br />., "J .. :' ;', ' < I \ ; .. ,",'.w I ,. I .: I' ~ . _' _ I .. '. '.' '.' ., j I ". ~
<br />THE TAXPAYER OR 'HEREAFTER ACQUIRED.
<br />Ai-1GUNT OF'TAX ill . . '" . . III . . . .. . . . . . .. 1,9.39.87
<br />PENALty. " ;.. . . . . . . " . ~ . '. . III . I . . 96.99
<br />l~TcRtS! (COM~U!ED lJ 02/19/1999) . . . . . . .. 3l~)'4a
<br />TYTA~AMOUN1DUt ................ 2,856.34
<br />'1 HEREBY C!RT1FV~T~AT THE NEijRASKA DEPAKTMENT~CF REVENUE HAS COMPLIED
<br />~llTH THi:"rfEVcNUE "-CA~jS OF 'HIE SlATE Of Nl::8RASKA IN THE DETERfUNATICN Cf
<br />THE M-lOUNT SHCi~N TO BE D.UE, AND THe: TAXPA)'ER HAS fAILED TG PAY 'THE
<br />AMOUNT Due AFTER DEMAND. IF THIS NOTlCE CF STATE TAX LIEN IS AN
<br />EXTENSION OF AN EFfECTIVE LIEN IT SERVES TO CONTINUE THE PRIORITY OF
<br />THE 5iAT~'S INTE~EST IN THE AffECTED PROPERTY OF THE TAXPAYER.
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<br />PREPAREK'S. ~lGNA1UR~
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<br />AUTH~R1Z~D SlGNATUR~
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<br />DA1ElTELEPHJNI;:
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<br />NEBRASKA DEPARTMENT OF REVENUE - White and Canary Copies TAXPAYER - Pink Copy COUNTY - Goldenrod Copy
<br />Prinled with soy ink 011 recycled papel 7.145-79 Rev. 1O-95l>uplr$tde$ 7.145.79 Rev. 5,91
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