Laserfiche WebLink
12/10/2009 THU 8:12 FAx 402 471 4429 UCC SECRETARY OF STATE yyy Hall <br /> <br />Please forward to: <br />Nebraska Department of Revenue <br />4500 Ave 1 PO Box 1500 <br />Scottsbluff, NE 69363-1500 <br />2oososs~s <br />~, <br />Nebraska Depertmerrt of <br />REVENUE <br />www.revenu®.na.gov <br />X004/007 <br />NE 5~C 4f Siai¢ John A Gal¢ - uCC STL <br />9909613656-3 Pg$~ 1 <br />GRp1MON JAMES K <br />Filed: 12l08l2p1D9 12:50 PM <br />NOTICE OF STATE TAX LIEN <br /> PLFJISE Da NOT WRITE IN THI SPAC <br />Thls 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 faxes constitute a Ilen <br />In the county for real and personal property belonging to the taxpayer <br />or hereafter ac uired. <br />Nebraska Iden6 lion umber Federal Identification Number <br />37289438 <br />Lien al Number Lien Flled Wlth Social Security Number Spouse's "al scanty Number <br />10933261 ®Re~ater of Deeds County Clerk XXX-XX-3424 <br />Date o Lien Lien ype County <br />12/t73/2o09 ®priglnal ~ContlnuationCorrected HALL <br />BU51NE55 NAME AND LOCA TION,ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br /> JAMES K GAMMON <br /> 2416 N KRlJSE AVE APT 3 <br /> GRAND ISLAND NE 68803 <br />Tax <br />Category Tax Period bate of Amount of Tax Penalty Interest Additions Balance of <br />Number Assessment Assessment Due <br />22 2006 D8/22/2009 367.41 18.37 67.37 453.15 <br /> <br /> <br /> <br /> <br /> TOTAL $ 453.15 <br />I hereby certi fy that the Nebras ka Deoariment aF Revenue has complied w ith the revenue taw s o the State of Nebraska rn the d etermination of the <br />amount shown to be du the taxpayer as failed to pay the amount due after demand. If this Notice of State lax lien is an extension of an <br />affective lien, it serves continue pr - oft estate's interest in the affected property of the taxpayer. <br />Revenue Agent 12/03/2009 (308)fi32-1206 <br />sign rep a Title Date el ne umber <br />here ^ Revenue Supervisor 12/0312009 <br />A homed Signature Title ~' Date <br />4.494.1914 Rev. 22002 Supersedes 4x94-1974 Rev.10.1995 <br />v <br />