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10/06/2009 TUE 14:33 FAX 402 471 4429 UCC SECRBTX#RX OF STATE y~+w Hdll <br /> <br />2oosososs <br />X004/005 <br />NL See e1 Stele John p 6e1• UCC STL <br />990960$911-0 P9s: 1 <br />Fi~led~10l06l2009 09:16 RM <br />~~_ . Notice of State Tax Lien <br />Nearaska ospartmentor <br />aEVENuE <br />PLEASE DO NOT WRITE IN TFIIS SPACE <br />INDIVIDUAL INCOME TAX <br />SOC. SEC. NO. <br />NEBR. IDENT. NO. <br />SPOUSE SOC. SEC. N0. <br />TAXABLE YEAR <br />LIEN N0. <br />COUNTY <br />DATE OF NOTICE <br />DATE OF ASSESSMENT <br />XXXXX2159 <br />39731480 <br />zoo? <br />091130],38 <br />HALL MARY R TRUJILLO <br />04/23/2009 6410 KARLSON DR NE #29 <br />02/05/2009 ALBUQUERQUE NM 87113 <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 . . 728.00 <br />PENALTY . 36.40 <br />INTEREST (COMPUTED TO 04/23/2009) . . 52.59 <br />UNDERPAYMENT OF ESTIMATED TAX PENALTY . 0.00 <br />TOTAL AMOUNT DUE ~. 816.99 <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 STATE'S INTEREST IN THE AFFECTED PROPERTY OF THE TAXPAYER. <br />.. ~: ~.Q.~........ .. ~~ ..... . ~~~i Ali c~~~-s ~a~ <br />PR P RER'S SIG TU TITLE ~ D~TE TELEPHONE <br />/ <br />•f~~~,~U, ?S U;C:... ..Irk. ~'d. ! ........ . <br />THORI D SIGNATURE TITLE DATE <br />IIT1b 11/QB <br />