200902496 - Laserfiche WebLink

Browse

04/03/2009 FRI 15:19 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall 1jlJ002/002 ~~ Please forward to: Nebraska Department of Revenue 4500 Ave I PO Box 1500 Scottsbluff, NE 69363-1500 200902496 F U GHErnv TlI'lOTHY G ps. : 1 ed, 04/03/2009 08:55 AN ~D....':::m G6 REVENUE ww_............u........oe.v NOTICE OF STATE TAX LIEN !- This Notice of State Tax lien is Issued by the Nebraska Department of RQvenue for "npald taxe, pursuant to the revenue Jaws ,of the state of Nebraska. Notice Is 'hereby given that taxes incl'udlng penalties and interest~ which'are shown below, a~ due from the taxpayer specified below and remain unpaid after demand. These taxes constitute a lien In the county for real and personal property belonging to the taxpayer or hereafter ae uired. Nebraska Ident lcatlon Number FederalldentificaUon Number 24353477 PLEAS NOT WRITE IN TH lien erial Number Lien Flied With !XIRegisler of Deeds Lien ype 03/31/2009 ~Onsi~'aIDContlnuation : BUSINESS NAME AND LOCATION ADDRESS BUSIness Name 90720562 Social ecurity Number Dcounty Clerk XXX-XX-4677 County o Corrected Hall TAXPAYER NAME AND MAILlNGADD~ESS , Spouse's Social ecunty Number Dille 0 lien Street Address City Tax Category Tax Period Date of Number Assessment 22 2003 03/05/2008 22 2004 03/1812008 22 2005 03/18/2008 22 2006 11/2,5/2008 22 2007 11/10/2008 Name Timothy G Daugherty street or Other Mailing Address 924 W 7th Street sign here City State Zip Code Grand Island NE 68801 Amount of Tax Penalty Interest Additions Balance of Assessment Due 5.00 1.25 1.68 7.93 2,051.00 512.75 564.62 3,128.37 134.00 33.50 28.85 196.35 292.00 73.00 43.66 408.66 995.00 268.75 68.97 1,332.72 TOTAL $ 5,074.03 ~ ! j- Revenue Agent TiUe Revenue Supervisor Title 03/31/2009 Date 03/31/2009 Date 4-<194-1974 Rev. 2.2002 8upt1'18de14-494-1974 Rev. 10-1995 ~/