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11/03/2p1p WED 15:18 FAX 4p2 471 4429 UCC SSCRETARY OF STATB y»� Hall <br />� <br />,• . <br />201048203 <br />.__.� .�.ra W� <br />���� <br />Nebraska Department af <br />RE�/ENUE NQTICE OF STATE TAX LIEN <br />www. revenuw,ne.gvv <br />This Notice of State Tax Uen is issued by the Nebraska Departmerrt of T <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Ne6raskn, Notice is hereby given that taxes including �penaltfes and <br />interest� which are shown below, are due from the taxpayer specifed <br />below and remain unpald after demand. These taxaa constitute a lien <br />in the county for real and personal property betonging to the #axpayer <br />or hereafter acauired. <br />32$70477 <br />14U47742 ' �C]Regtster of Daeds �County Clerk )QO(-XX-Q229 <br />]ate of ien Lien ype County <br />11/01/2010 �Original �Continuation �Carrected f{qLL <br />BUSINES$ NAME AND LOCATlON AI]DRESS 1'AXPAYER NAME AND MAILING ADDIi�SS <br />JASON C LAWHORNE <br />71p S KIM9ALL ST <br />GRAND ISL,AND NE 6$801 <br />Cetegory Tax Perlod ' pate of <br />Number Assassment <br />z2 2004 05/04/ZQ10 <br />22 2005 12/20/2009 <br />Amount of Tax <br />178.QQ <br />4,3Q4.98 <br />Penalry <br />44.50 <br />1,076.24 <br />I�002/006 <br />Interest I Additions <br />63.15 <br />1 <br />TOTAL <br />am0unt shbwri <br />effective lien, it <br />slgn � P <br />here ► <br />dua, <br />6,935.B9 <br />�°rwu������ �, R�Ya��,�� cvmpuea wr[n [na revenue Iews af the 5tate of Nebraska in the determinaqon o the <br />ta�ayer has failed tn pay the amaunt due efter demand. If this No6ce of State Tax Lien is an extension of an <br />ihe ' f the s te's interest in the a�ected property vf the ta�a er, <br />Revenue P�gent � t � I � 0 (308)632-1210 <br />t e le e ephone Number <br />� Revenue Su ervisor ( l i � <br />� Title aate <br />�49�-f07� Rev. z-s0�s Suprrsw.. ��194197� Rev.laloas <br />ealance ot <br />As�esament �ue <br />285.65 <br />6,650.0�{ <br />r <br />/ <br />