Laserfiche WebLink
01/14/2005 16:43 FAX 14024714429 NEBRASKA UCC fj002 /004 <br />a1pslNit/0nt <br />otratieFN4� <br />200500462 <br />NOTICE OF STATE TAX LIEN <br />PLEASE DO NOT WRITE IN THIS SPACE <br />This Notice of State Tax Lien is Issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice is hereby given that faxes 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 acquired. <br />Nebraska Identification Number Federal Identification Number <br />9141480 <br />Lien Serial Number Lien Filed.With Social Security Number Spouse's Social Security Number <br />35161 X❑ Register cf Deeds [] County Clerk 508 -12 -0722 <br />Date of Lien Lien Type County <br />01 /10/2005 ❑x Original a Continuation ❑ Corrected . Hall <br />BUSINESS NAME AND LOCATION ADDRESS . TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Name <br />Denneta M Klinginsmith <br />Street Address Street or Other Mailing Address <br />1612 W Hagge Road <br />city State Zip Code City State Zip Code <br />(;rnnrl Ielonril h P M canna <br />Tax <br />Please Teturn to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2ND ST STE 460 <br />Category <br />GRAND ISLAND NE 68803 <br />or <br />Amount of Tax <br />Penalty <br />a1pslNit/0nt <br />otratieFN4� <br />200500462 <br />NOTICE OF STATE TAX LIEN <br />PLEASE DO NOT WRITE IN THIS SPACE <br />This Notice of State Tax Lien is Issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice is hereby given that faxes 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 acquired. <br />Nebraska Identification Number Federal Identification Number <br />9141480 <br />Lien Serial Number Lien Filed.With Social Security Number Spouse's Social Security Number <br />35161 X❑ Register cf Deeds [] County Clerk 508 -12 -0722 <br />Date of Lien Lien Type County <br />01 /10/2005 ❑x Original a Continuation ❑ Corrected . Hall <br />BUSINESS NAME AND LOCATION ADDRESS . TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Name <br />Denneta M Klinginsmith <br />Street Address Street or Other Mailing Address <br />1612 W Hagge Road <br />city State Zip Code City State Zip Code <br />(;rnnrl Ielonril h P M canna <br />Tax <br />Category <br />Tax Period <br />Date of <br />Amount of Tax <br />Penalty <br />Interest <br />Additions <br />Balance of <br />Number <br />03/ 1/200 <br />Assessment <br />Assessment Due <br />01 1130/200 01/06/2005 4,708.05 630.69 136.23 5,474.97 <br />TOTAL $ 5,474.97 <br />3 hereby cenery tnat,tne.NebrasKa Department of Revenue has complied with the revenue laws of the State of Nebraska in the' <br />determination of the amount shown'to be due, and the taxpayer has failed to pay the amount due after demand. If this Notice of.State <br />Tax Lien is an extension of effective lien, it serves to co unue the priority of the state's interest in the affected property of the taxpayer. <br />sign i SID J� 308 385 -6073 - <br />► ` <br />g Pre arer's Signature Title Date Telephone Number , <br />here ► <br />Authoriz d a re Title Difie <br />41494 -1974 Rev. 2.2002 Supersedes 4494 -1974 Rev. 10 -1995 <br />