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<br />02/10/2009 TUE 10:50 FAX 402 471 4429 UCC SECRETARY OF SXATE ~~~ Hall <br /> <br />121002/002 <br /> <br />db <br /> <br />liE 5.. ., s..,. J.hn A 6.1. - UCC !IT~ <br /> <br />200900911 <br /> <br /> <br />Please forward to: <br />Nebraska Dept of Revenue <br />~500 Ave I PO Box 1500 <br />)cottsbluff, NE 69363-1500 <br /> <br />9909586472-1 Ps~, 1 <br />RRMIREZ RNTONIO JR <br />Filed, 02/10/2009 09,29 RM <br /> <br /> <br />...~ <br />N&braskiil Depilrtmenl: of <br /> <br />REVENUE <br /> <br />.WWw.revenud.ne . UDV <br /> <br />Notice of State Tax Lien <br /> <br />PL.EASE DO NOT WRITE IN THIS SPACE <br /> <br />INDIVIDUAL INCOME TAX <br /> <br />SOC. SEC. NO. <br />NEBR. IDENT. NO. <br />SPOUSE SOC. SEC. NO. <br />TAXABLE YEAR <br />LIEN NO. <br />COUNTY <br />DATE OF NOTICE <br />DATE OF ASSESSMENT <br /> <br />XXXXX4944 <br />31186475 <br /> <br />2005 <br />081930203 <br />HALL <br />07/11/2008 <br />04/28/2008 <br /> <br />ANTONIO RAMIREZ JR <br />419 WEST AVE <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, 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 />AMOUNT OF TAX . . . . . . . . . . . . 496.00 <br />. PENALTY . . . . . . . . . . . . . . . 24.80 <br />INTEREST (COMPUTED TO ~:2/051pay:; ) . . /03,11 <br />UNDERPAYMENT OF ESTIMATED TAX PENALTY 0.00 <br />TOTAL AMOUNT DUE . . . . . . . . . . 6"),,3,9/ <br />I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED <br />WITH THE REVENUE LAWS OF THE STATE OF NEBRASKA 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 />THE TATE'S I EREST IN T~FFECTED PROPERTY OF THE TAXPAYER. <br />. . . .~ 4n~~ P. . . . . . ;tf9 t67. f':<<)~31:--:J1-CD <br />TIT ;-r-'-:: ' DATE(~'~EPHONE <br /> <br />TITLE . . . . . . ..~ ... o"ifJI?1. . . . . .0 <br />0\~ <br />11r;~~ <br /> <br />