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03/14/2011 MON 15:05 FAX 402 471 4429 UCC 5ECRETARY OF STATE ��� Hall <br />-� 12/18/2003 09:C7 F1►� 14024'144Y9 NEBRASBA GCC <br />/�t <br />� L` <br />, <br />N <br />�� <br />���� <br />�� <br />�� <br />20�.10203G <br />���,�: - . . , <br />STAIE OF NEBRASKA� � � <br />D�PARTIv�NT OFRBVENUE • . " <br />1811 WEST 2� ST STE 46D . .� <br />GRAND ISL.'�ND NE 68803 ` ' . � <br />(�007/007 <br />lQ� 003!003 <br />�oa►������ <br />� <br />i_r <br />.�/, . <br />i�� � <br />� t-� �- <br />, ... <br />. <br />NOTiCE �F STATE TAX LIEN <br />, . PL�ASE DO NOT WRITE IN THIS SPAGE <br />This Nutice af StaEe Tax 4ien is lssued by the t�ebraska Department of <br />Revenue }ar unpaid taxes pursuant to the re�enue la+ws of the state of <br />Nebraska. Nofice is hereby given fhat taxes Includir�g penalties a�d <br />intere�t, which ar+a shown 6eiow, are due� from the faxpayer specifie� ��C�j T'p <br />befow and remain unpald after demand. These taxes constltute a tlen �� Z <br />in the caunty for real and personal pr��serty belonging tv the taxpayer <br />or h�reafifer acquirsd. � � • � � • • � • � • � � � <br />!�ebraska idtntily.�tion Nurtiber ;..:,�. _'.. LieA F.iie�.'W�h_::..: � ''' � Social SeCUrity t�urhber Spouse's Sodai Secu�iy Number <br />.......... :` •11�51Q9a5 ,_...�. ORegi's�r"or�eeds' "[ICoiur'hjGe��c ... ' xxu-,cx��i01 . ._ �,. . �xx-xx,=8592 <br />L'en 5ariai�l�mbor � _._. .. .. - Lien .. .. . •. ... .�� . . OaEe•of lien. .. . . {Casn;y . .-- _-_.., .. . ._ <br />jZ � ,�X Original �Ccntinuation ❑eoRec�ed 1211212003 Hall <br />BUSINESS 1iAME AND LOCATION ADDRESS TAXPAYER NAME lWD lAA1lIHG ADDRE55 <br />0 <br />Category <br />Numb�r <br />2z <br />22 <br />Name <br />Jerry" L 8� Carola L Denion <br />strzet ar Other Maalrg AAdress <br />2U5 S Cedar <br />Zip Coce C+ty St2te 2ip Cod <br />Gr�nd isiand NE 88507 <br />i'ax Period � Date of � Amount ot Tax � Penalty f Jnterest , Ad�itions <br />1999 03/27/2001 � : 1,408.00 <br />2000 03l12/2402 i 2,fi02.00 <br />352.00 495.70 <br />734.5a 683.71 � <br />358.90 259,9? I <br />22 ) 2Q01 ' 11112/20Q2 � 2,339.00 <br />B21a�ce of <br />sesament [ <br />2,256.70 <br />4,020.21 <br />2,957.81 <br />- � . . ... • .. . � , • : .. . <br />... . .. _ . . :. _ __..._.._ . � 4 . . .. _._ . .. .. :• -��.: TOTEIL _. . � ... 9.234.72 <br />� f t�erehy periify Ihe Nebraska 66pa�ment,ot Ravenue bae ca wifh �^e reqe�x►a layvs oC the S�ke of Ne6ra�ka in tne <br />� �determ;na�ia�:of the'amount shovm to te'due, a�Q !}:e. taupaye�-has lailed lapay tttiA arncunt due aitor demand. {f fhir Ncqca af Stata .� .: . <br />� Tax Li ar e� sio� af an e ve 'e�, it serves �o con�nue the prior�ty of 1ha ata►e's interest tn the aifected property of tho tvc�ayar. <br />' �LlJ} �� TSS -^ f.J '�J '�' 308 385-6Q67 <br />S19 f� � PieFarere 5igna;ure . itle �!e Ta�ephone Number <br />here � � Revenue Supervisor ��c� 3 <br />� <br />Ai;lh ' a , Tltle ( �� <br />�.,s,��a��ae�.z S ����c'��.aS�-19T <br />'�1 �,l:r�c � c� <br />