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06/15/2011 6�ED 14:16 FAX 402 471 4429 UCC 5ECRETARY OF STATS -��y eall <br />�� <br />� <br />�]( Register of Deeds �County Clerkf XXX-XX-9336 I XXX-XX-1540 <br />@looz�ooz <br />�� ���� <br />Ne6�aska.D�pa,rtment of <br />��V��� J� NOTtCE OF STATE TAX LtEN <br />www.�evenue.ne.flov <br />This Notice of State Tax Lien is issued by the Nebraska Department of <br />Revenue for unpatd taxes pursuant to the revenue laws of khe state of <br />Nebraska. Notice is hereby given that fiaxes includir►g penatties 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 persanal property belonging to the taxpayer <br />or hereafter acauired. ' <br />29649447 <br />11156879 <br />06/14/2011 I�]Original [�Continuation <br />BUSINESS NAME AND LOCATION ADDRESS <br />Category Tax Pedod Date of <br />Nurober Assessmet <br />22 2006 03/16/2009 <br />Amount ot Tax <br />20��04471 <br />❑Cor�ec►ed I HALL <br />TAXPAYER NAME AND NWUNG ADDRESS <br />LUCILLE K BURNETTE <br />HOWARD BURNEITE, DECEASED <br />313 S KIMBALL <br />GRAND ISLAND NE 68801 <br />pena�ty � i�erest <br />Add�lons � Batance oF <br />Assessment Due <br />356.00 I 17.80 I 92.49 <br />as6za <br />TOTAL � $ 466.29 <br />i he�edy canty tnac tne iveenrasica uepartment ot Revenue nas �mpl�ea wttn tr� r�renue iaws o� me �m�e or nen�Ka m rne as�errrvnanon ar �e <br />amount shown to be due, and the ta�ayer has felled to pay the amow�i due after de�nand. If this Natice of Sfate Tex Lien is an eactension of an <br />effec�ive lie,n, ft s r�� ta c�ntinue �e prior�ly of the state's �tere.at in tF� affected propedy of the tax�ay <br />� � �%� u,0 RevenueAgent �' � � (402�71-5788 <br />srgn P er' ign Title ate el umber <br />here ► ` Revenue Supervisor l <br />Auttarized Signature Titla Date <br />4�484-1874 Rev. 2•2W2 Supersfldes 4-494-18�4 Rev. 70�1995 <br />i <br />