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<br />09/15/2008 NON 15:38 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall
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<br />~003/003
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<br />lNP1,VltlUA,L INCOM:.. ,AX
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<br />sec. S,i:C.' NO. ~:30l:38951
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<br />DAT: Of NC11.Cf .,.' '-:.l.l106'/9t;., ..'.:; "0/0 ,~C H'tJ'Y7c9"
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<br />lHIS NC'TICE Uf ST~lE TAX tl'EfiiIS ISSUiD 6V THe NEe~AskA OEPARHl€NT SF
<br />K!::vENUE fGfil li'iDl\11DUA'l INCCME TAX' PURSUANT TC liiE kEVHzUf lA\o.iS OF T~E
<br />"$,T A T~ Cf NEER ASrr.iA- NeT'ICE IS HER-E&Y' G.IYEN ..TflA 1 INDIV'lDlJAl 1 f'lCGME
<br />.T Axes ;lNCltJDliolG, peN-A~ TIES ANi! .LtHE-R.:fST, WHICh A'R_E'stiCWt'l .BELOw ARE 'tU'i
<br />'..FRCt<1 TH.~_'JA)P:AYER: 'S.p;;.CIF1~'.t. AiiOVE ~.WD 'R_l::t>t6!N UNPAID. A'FTER DEJIIIAND.'
<br />THES:E ll\xes" CCffSTI1,(Jli' It LIEN' IN- nu: C'OUN-1Y Fan:. J'ROPEr\TY BfLCNGH;G TO
<br />.1f:if TA;(FA.'(-E.R .CR HSHE,A:F'lE'R AC'lJ'IRi:.D. _ .;' '~""
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<br />PENALTY.. ...'~ .. .. ..." .. .. .'~" .. . . . .. ,70.:,0
<br />IN1EREST (C8~PUTEOTO ll/d~/96) . .' ~ .. .. . . . ~9.e4
<br />TeTAL AMCUNT DUE ... ~ ~ . . .- . . ~. .. . .. ~q2.~~,
<br />1 tif::rt.tE't' cern lFY THAT The' ltcE6?.A SKA tE"fl1<.RTM€jH OF RtVf:hlit: HA:) CCf'lf L i~C
<br />W~'lti HiEll'iENUf: LA...:; (a~' TH~ ,S.lAtE Cfhf.:J3RASf:.A IN THi:: Dl:TE:RMINATICN Cf
<br />.,,'tH':: A~Cl!"ff Sti(;wN' 1'0 BE DUE, A/'.lD'7-Hi~"TAXP'A:YE-R "hAS fAIlEL TO PAY nit.
<br />AMGUNl CUE AfTER ~E~A~D. ]f ThIS ~OTltEQf STATE lAX LIEN IS AN
<br />EXl€'NSlbN OF .AN EfF.ECTIVE; L.U:N IT 'SERVES TO CONT!Nl1E ThE fR!C~!T" Cf
<br />tHE SlATE'S INTeREST'IN TME AFFECTED PROpeRTY GF~THE TAXPAVE~.
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<br />NEBRASKA DEPARTMENT OF REVENUE - White and Canary Copies
<br />PfinIfId wrlIl.ay,-if!k QfI recp*d fNIIJfV.
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<br />TAXPAVER - Pink Copy COUNTY - Goldenrod Copy
<br />7-145-79 Rev. 10-95 Supnede, 7-145-7V Rev. 5.Q1
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