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07/11/2011 MON 10:18 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br />f�ooz/0oz <br />� �� <br />2o�i���o� <br />� <br />Nebraska DapaRment of <br />REVEIVUE u�cN�qo�ta� �3o-t TE TAX LlEN <br />www..evenue�. �e.g cv <br />r�.r�'i <br />This Notice of Sfate Ta�c Lien is issued by the Nebraska Department of <br />Revenue fo� unpaid taxes putsuar�t to the revenue laws of the state oi <br />' Nebraska. No�ce is hereby glven that taxes Including penalties and <br />inf�rest, whtch are shown below� are dae from the taxpayer specified <br />6elow and remaln unpaid aftsr demand. Thase tax� constitute a lien <br />In the county for rea! and personal property belonging to the taxpayer <br />o� hereaiter acauired. <br />40195688� <br />2520144 <br />� <br />�R�isisrol0eeds �CountyClerkl XXX XX.3174 <br />01/11l2Q02 �Originel �Contire�ation �Cocrected HALL <br />BUSfNESS NNNE ANO lACATION MDRESS . TN�PAYER NAlVlE AND MAILING <br />� ' JACOBSlDARWIN J <br />� 6101 SEQUOJA H 10 <br />, ALBUDUERQUE NM 87120 <br />Category <br />Num6er <br />22 <br />Taz Perbd 1 Date of <br />1998 I �R712000 <br />AmountotTax Penalty <br />2Q�.�0 10.05 <br />I�erest I AddiDions <br />30.93 <br />Balaace of <br />�ssm�= <br />241.88 <br />TOTAL IS 241.98 <br />� nar�y o�u�y u� u�e neorasKa ueparunear or rteuenue naa oomp�ea xn�h tne revenue �uus o� tne �aie o� aeaas�a m u� determmauon m uu <br />amo�tsF�xm to Ge d�. end tt� la�ayer has 6�ed la pay U�e amaud due afl�demand. N Uds kct�e of Staia Tax !i� is an e�ion of � <br />ef�cXive lien, it ssves U� aauinua the ''ty d the ste�e'81rae�st in fhe aftected properly of fha t�cpa�r. <br />� � Revenue AgeN � � � + (402}471-5928 <br />s�gn pa na iue e � T er <br />here ► Revenue 5upervisor <br />arlF� signatiue r,ne � Gate <br />asa4197sRw.2��swuwde►b�eate7�Rw. fataes <br />. � <br />