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12/14/2010 TUE 15:10 FAX 402 471 4429 UCC SECRETARY OF STATE Hall 0002/004 O me fee of sia4e John A 6111 - UCC %Cm - 201009339 993064S3t;1-3 Poo: 1 HERNANDEZ EDUARDO Flled: 12114/2010 12:13 PM i Nebraska Department of REVENUE.. N STATE TAX LIEN www.revenua.nri.gpv V G~L6((f+v9id NOT WRITE IN THIS SPACE PLEASE This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are shown below, are due from the taxpayer specified below and remain unpaid after demand. These taxes constitute a lien j in the county for real and personal property belonging to the taxpayer or hereafter acquired. Nebraska Identification Number Federal Identification Number 41033256 Lien Serial Number Lien Filed With Social Security Number Spouse's Social Security Number 0>3430048 ®Register of Deeds County Clerk XXX-XX-1419 Date of Lien Lien Type County 05/09/2001 DOriginal ®cortinuation Corrected HALL. BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS HERNANDEVEDLIARDO 743 CONCHO ST EAGLE PASS TX 78852 i" ax Category Tax Period Date of Amount of Tax Penalty Interest Additions Balance of Number Assessment Assessment Due 22 1997 10/2312000 1,120.00 56,00 309,31 .00 1,485.31 i. TOTAL $ 1,485.31 I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in the determination of the amount shown to be due, and the taxpayer has failed to pay the amount due after demand. If this Notice of State Tax Lien is an extension of an effective lien, it se es to continue he priority of the state's interest in the affected property of the taxpayer. Revenue Agent It 1) (402)471-5928 sign Prepar Si n0- i0e Date Telephone Number here I V11, Revenue Supervisor Authoriz ignalur Title Dat 4-494-1974 Rev. 2-7002 Supersedes 4-494.1974 Rev, 10-1995 i Y~ •