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12/30/2009 w78n 14;30 PAX 402 471 4429 UCC SECRETARY OF STATE ~~y Hall <br />Please forward to: <br />Nebraska Department of Revenue <br />4500 Ave T PO Box 1500 <br />Scottsbluff, NE 69363-1500 <br />i~1002/002 <br />N[ feC of f~~ii Jahn A 610 I1CC 5T1. <br />9909615417-i Pgs: 1 <br />MACHAR JAMkS M <br />Filed: 12/30/2008 08:80 AM <br />~oogioas9 <br />Nebraska pepartment' of <br />REVENGE NOTICE OF STATE TAX LIEN <br />wwvlr. raven u4-. nn, avv <br /> PLEASE DO WRITE IN THIS SPACE <br />This Notice of State lax 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 wired. <br />aska Identi cation Num era dentiAcation Numtxar <br />99261502 <br />en a umt~er en dh 'al 5aanty um r Spouse's al city Number <br />10933783. ®Re~ister of Deeds ~Cour-ty Glerk XXX-XX-9538 <br />Date o Lien ype .. !Cawty <br />12/28/2009. ®Original QConlirwaGon Corrected HALL <br />BUSINESS NAME AND LOCA TION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br /> JAMES M MACHAR <br /> 311 3RD ST APR 21 <br /> GRAND ISLAND NE 68801 <br />ax <br />Category Tax Period Date of Amount of Tax Penalty Interest Additions Balance of <br />Number Assessment Assessment Due <br />22 2D05 03/25/2007 112.00 22.1 D 8$.98 233.08 <br />22 2006 03/24/2008 132.00 6.80 24.62 163.22 <br /> <br /> <br /> <br /> 70TAL $ 396.30 <br />I hereby certi that the Nebras ka Department of Revenue has compiled vnth the revenue laws the fate o et>raska in the determination of the <br />amount stxawn to be due. and t he taxoaver has f aileH to oav the amount dl>a a1tPr demand it rhea t~nrrra ~ titara rev i ian la a~ ~,n~,~~~~ „r fln <br />effective lien es to condn ~ n 'ty of th state's interest in the affected property Of the taxpayer. <br />' Taxpayer Services Specialist it 12/28/2009 (308)632-120D <br />sign s ature i e Data eJephane umber <br />here - Revenue Su ervisor 12128/2009 <br />Authorized TiNe Date <br />4.484.1974 Rav. 2-20D2 Superoadas 4-484-1974 Rsv.10.1985 <br /> <br />