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12/27/2p10 M0� 15:36 FAX 402 471 4429 UCC SBCRE�ARX OF STATE �yy Hall <br />�il��, <br />I�004/004 <br />N� Ssc o! Staka John R 6ale - U[[ SrL <br />9910646478-9 P9s: 1 <br />OWENS JAYFIE R <br />Filed: 12/27l2010 08:04 qM <br />2oioo9�2� <br />�� <br />Nebraska 17epanment of <br />REVENUE NOTICE OF STATE TAX LIEN <br />www.revenue_ne.gnv <br />This Notice of 5tate Tax Lien is issued.by the Nebraska Department of <br />Revenue for unpald taxes pursuant to the revenue laws of the stata af <br />Nebr�aska. Notice is hereby glven that taxes including pena�ties and <br />interest, wh(ch are shawn below, are due from the taxpayer speclfiad <br />6elow and remuln unpaid after demand. These taxes constitute a Iten <br />in the county for real a,nd perspnal property belonging to the taxpayer <br />or hereafter acauired. <br />99a37376 <br />11049807 <br />�Register of Deeds �County Clerkl XXX-XX-3�389 <br />12/22/2010 ��riginal �ContinuaGon [�Corrected I�{qLL <br />BUSINE5S NAME AND LOCATIQN ADDRESS TAXPAYER NAME AND MAILING ApnRE55 <br />JAYME A OWENS <br />602 S CL�BURN <br />GRAND ISLAND N� 68$01 <br />Category Tax Period Date of <br />Numbe► Assessmer <br />22 2D08 07l24/2p10 <br />Amount of Tax Penalty <br />212.Q0 10.60 <br />Interest <br />17.89 <br />240.49 <br />TOTAL � $ z�o.as <br />�••���� ����� �,�, „ �G �•�a�a ��Np�u������ �� RC�,�un nas comµiea vnm me ravenue iaws or tne state ot NeCraska in the delerminatiun of the <br />amaunt shown to be due, and the la�ayer has failed to pey the amaunt due after demand. If this Netice ot 5tate Tan Lien is an extensinn o( an <br />effecGve lien, il serves W continue the priori pf the sbte's interest in lhe affected property of lhe ia�ayer. <br />� Revenue,�gent /� � Z2 /D (308)B32-1203 <br />sign Prep i TiUe f �ate Tele ho umb <br />here ■ Revenue Su ervisor f� �/(� <br />nrized Signature Title p� <br />�1841674 Rev. Z-2002 Supeliedes H9�187� ReV.10-1BD5 <br />Additlona I Balancw af <br />Asseasment Due <br />