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02/24/2005 17:50 FAX 14024714429 NEBRASKA UCC <br />200501564 <br />10005/005 <br />F Pm <br />Or Notice of State Tax Lien <br />nebraska <br />depertmient <br />of revenue PLEASE DO NOT WRITE IN THIS SPACE <br />INDiVIDUAL INCOME TAY <br />SEC* mce, 50 -9 54;85487 <br />;.E -DR- IDENTe, NOD- .116716 5 3 <br />SEC, NQ, <br />AXAB- LE YEA R v"O 3 <br />LIEN NCe 04.2.03003-S <br />COUNTY HALL HOWARD, L SCCH'MITT <br />DATE OF NOTICEE 10129/7-004 322 SO PLUM; ST <br />DATE OF ASSESSMEMT J_/WY/20CV4 GRAND NE &F,80_1 <br />STL <br />THIS NOTICE of STAIE TA L� _- j r� rl_ <br />U t r_ TAX L70H IS ISSU-0 BY THE NEBRASYA DEPARTKENT rjF <br />RZVENILIE POR -:MDIVTn l:,AL lKETAF TAX PURSUANT TO THE REVENUE LAWS OF THE <br />-NOWT ; <br />S T A 7 F 01 -F NEBRASKA* Xf-lICE IS HEREBY GIVEN "HAT INDIVIDUAL INCOME <br />TAXES INCA U'IDING PENALTIES AND'INIMRESTv WHICH ARE SR VWN BELOW ARE DUE <br />FROM THE TAXPAYER SPECIFIED ABOVE AND RZEMAIN UNPAID AFTER DEMAND* <br />THESE TAAKES CONSTITUITS At LIEN IN THS C-CLINTY FOR FROPE.RTY BELmIGINS TO <br />THE TAXPAYER OR HEREAF7ER ACQ!UIRED, <br />AMOUNT '06F TAX 2,1540*00 <br />PENALTY * * - 599-00 <br />lNTEREST TED 11011_29/20C-41 82025 <br />TG AL AMCUNT DUE <br />l-V <br />NT OF REVINVE HA S COYP <br />L <br />E"R=sy CVRT7y _llHl_ rHz NEBPASKA DEPARTM A_ <br />WITH THE REVENUE LAWS OF THE STATE OF r.4EBqASKA IN THE DETERMINIATION OF <br />e_ it - ANn THE TAXPAYER HAS FAILED TO PAY THE <br />THE AMOUNT SHOWN n B_ ZUTv 4� FAILED <br />AlMOUNT DUE AliFTER DEMAND* IF THIS WK7TE OF STATE TAX LIEN IS AN <br />EX- PENSION OF AN E=VCT"VP LIEN IT, SFRVF-' 7C CONTINUE THE PRIORITY OF <br />LIEN <br />!N T i47 ACFECTED PP.CPERTY Of THE TAXPAYER- <br />211 <br />P R EP A R E R 'j S _S": T A NR FF T L �iZ DATEE/7ELEPHUNE <br />7 <br />/ AN066'Ve <br />TTYA DATE <br />NEBRASKA DEPARTMENT OF REVENUE — White and Canary Copies TAXPAYER — Pink Copy <br />7-J45-1979 Rev. 2.2oW Supereedes 14s197e Rev. IG-1995 <br />P,f,h,q -wih wv k* on reoVdad paper <br />