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12/18/2009 FRI 14;12 FAX 402 471 4429 UCC SECRETARY pF STATE ~~y Hall <br />Ia1003/003 <br />NE Sso w1 Sl~ir Jahn R 6~1e l1Ct STL <br />20090995E <br />;. <br />9908614613..9 pgS ; t <br />HALPINE PRTRICte <br />Filed: 12/18/2009 08;58 RM <br />~twebreake U}#y~i¢rts7M~brh't od <br />~''E~E NOTICE OF STATE TAX LIEN <br />'Y V+RV`IM.7C tll~drYnkrr!. wr.q ie~V' <br />This Notice of State Tax Lfen is Issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. NotlEe is hereby given that taxes including..penaltiesond - <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 />9893652 <br />aRegister of Deeds County Cleritl XXX-XX-1417 <br />11/19/2009 ^X Original Continuation ~Corrept~d, HALL. <br />BUSINESS NAME•AND LpCATION ADDRESS '~ `~ TAXPAYER NAME AND MAILING ADDRESS <br />PATRICE HALPINE <br />or Other Mailing Address <br />611 SOUTH WASHINGTON <br />GF:AND ISLAND NE 68801 <br />Tax <br />Gategory Tax Period Date of Amount of Tax Penalty Interest Additions Balance of <br />Number Assessment Assessment Due <br />01 1/1/06 - x'1/07/2009 ~ 503.59 50.36 100:21 654.16 <br />1 x'!31 /2005 <br />01 1/1/07 - 01/07/2009 407.19 40.72 4$.45 496.36 <br />12/31 /2007 <br />01 1/1/08 - 05/06/2009 736.70 73.67 30.07 840.44 <br />12/31/2008 <br />PLEASE RETURN COPY OF <br />FILED LIEN TO: <br />NEBRASKA DEPT OF REVENUE <br />304 N 5TH ST'STE D <br />NORFOLK NE 68701-4091 TDTAL $ 1,990.96 <br />I hereby certify that the Nebraska Department of avenue has complied wit the revenue laws of the State o Nebraska in the determination of the <br />amount shown to be due, and the taxpayer has failed to pay the amount due after demand. If this Notice of Slate Tax lien Is an extension of an <br />effective li , it serv s continue ~ ty oft tote's interest in the affected property of the taxpayer. <br />avenue Senior A ant ~ 402 370-3501 <br />talgrl Prepare re Title D e Telephone Number <br />here Revenue Supervisor ____ _ ~~. ~~ ~} ~~ <br />Authorized Signatu Title .~ Date ~' <br />4.484.1974 Rev.2-20~Z Supersedes 4x194-1974 Rev. 10-1995 <br /> <br />