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06/25/20D9 THU 14:00 FAX 402 471 4429 UCC S8CR8TARY OF STATE ~~~ Ha11 <br /> <br /> <br />Please forward to: 2 Q Q 9 iQ 5141 <br />Nebraska Departrnfrnt of Revenue <br />X500 Ave I PQ Box 1500 <br />Scottsbluff, NE 69363-1500 <br />X002/002 <br />NE Sea aP Ststs Jnhn q 6a1^ - tlC[ STl <br />99®9600477-0 Pga: t <br />FA1ed~z0B/25!2009 09:40 AM <br />Nebraska pepartmerrt of <br />REVENUE NOTICE OF STATE TAX LIEN <br />www.raven~a.na.gov <br />- - ---- <br />his Notice of State Tax Iran is issued bytha~Nebraska• Department of <br />Revenue for unpaid takes pursuant to the revenue laws of the state of • - <br />Nebraska.. Notice is hereby given that taxes including penalties and <br />interest, which are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These taxes constitute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter acauired. <br />19588981 <br />090790.022 <br />®Register of Deeds County <br />06/23/2009 I ®OrigirmlContinuation <br />BUSINESS NAME AND LOCATION AppRESS -T <br />XXX-XX-8489 <br />^~ HALL <br />TAXPAYER NAME AND MAILING ADDRESS <br />VICENTE T VALAI7EZ <br />408E 16TH ST <br />GRAND ISLAND NE 68$01-3836 <br />Catsgary Tax Period Date of Amount of Tax Penalty Interost Addttinns Balance of <br />Number Assessment Assessment pua <br />22 2005 03!20/2009. 709.Op 35.45 181.08 905.53 <br />TOTAL $ 905.53 <br />I her certify that th N ska Deparhnent of avenue s coin red with the revenue laws of a fate lxaska in a determination of the <br />amount shown to ,.and the has failed to pay the anxtunt due after demand. If this Notice of State Tax Lien is an extension of an <br />effective lien, ft serv to Conti ue the ority of the state's interest in the affected propeAy of the taxpayer. <br />Revenue Agent Ot3/23/2009 (308)632-1206 <br />sign lure Title <br />here ~ Date a ephone umt~er <br />Revenue Su ervisor osrz3/2oo9 <br />u or'ized Sig Title pad <br />~a94-1974 Rov. &2002 Superaedea H9A-197 Rev. 10.1998 <br />. V <br />