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10/27/2009 TU8 ].5:06 FAX 402 471 4429 UCC SECRETARY pF STATE +yw Ha17. <br />2oosos57~ <br />~002/p09 <br />NE ere of sielr Jahn R Gal• - 11CC sTL <br />9909610519-7 Pgs: 1 <br />CRRVEN RpI.PH M <br />Filed: 10/27/2009 08:12 pM <br />~:. <br />~~~ hle`br-asCtl;t. DeRartmertt of <br />-: _~ :`` <br />NOTICE OF STATE TAX LIEN <br />~. <br />t~vi~~~,~~~taF;:;~~~r <br /> PLEASE DO NOT WRITE IN TWIS 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 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 ac uired. <br />Nebraska I enh cation Number Federal Identification Number <br />4361598$ <br />Lien erial um er Lien Filed With ocial Security Number Spouse's Social Security Number <br />10931202 ®Registerof Deeds ~Caunty Clerk XXX-XX-8008 XXX-Xk-4332 <br />Date of Lien Lien Type County <br />10/22/2009 ®Original ~ConGnuation Corrected MALL <br />BUSINESS NAME AND LOCA TION ADDRESS TAXPAYER NAME AND MAILING ADDRE33 <br /> RALPH M & KIMBERLY L CRAVEN <br /> 411 FEDERATION ROAD <br /> TWIN FALLS ID $3301 <br />Tax <br />Category Tax Period Date of Ampunt of Tax Penalty Interest Additions Balance of <br />Number Assessment Assessmett Due <br />22 2005 1?J08/2006 1,944.09 173.20 721.67 2,838.96 <br /> <br /> <br /> <br /> <br /> TOTAL $ 2,838.96 <br />I hereby certify that the Nebras ka Department o Revenue has complied with the revenue laws of the State of Nebraska in the determinafwn of the <br />amount shown to be due. and t he taxoaver has f ailed to eav the amount due aker demand. If Chic Nntirp of StAtFd TaY 1 ion is an oYlvneinn of an <br />effective lien, it se es to continue the pri rity of the state's interest in the affected property of the taxpayer. <br />f/(. ~ ~ Revenue Agent 10/22/2009 (402}471-5835 <br />Sl~fl Preparers Signature itle Date elephone Number <br />hero ! Revenue Supervisor 1a2z/2oos <br />,._,..- <br />thorized Signa Title Date <br />4-494.7974 Rav. 2 202 SupeYaedas 4-494-1874 Rev.10~1995 <br />v <br />