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08/11/2011 T8U 14:58 FAX 402 471 4429 UCC SECRETARY OF STATE -�y-� 8a11 <br />� <br />�,p�10599 <br />����� <br />�II�"`'�E���E <br />ww�ritv�.wnsr��raW.�.r�.�r�vr <br />�ooa/ooz <br />NOTICE OF STATE TAX LIEN <br />This Notice of State Tax Lien fs issued by the Nebraska Department of <br />Revenue for unpaid taxes pursua�t to the revenue laws of the state of <br />Nebraska. Notice is hereby given that taxes including penalttes and <br />interest, which are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These taxes constltute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter acauired. <br />10710574 <br />�X Registar of Deeds �Counry Clerlcl XXX-XX-4589 <br />08/04/2091 I QOriginal []Continuation �Carrected I HALL <br />BUSINESS NAME AND LOCATION ADDRE3S TAXPAYER NAAAE AND MAILING ADDRESS <br />BLANCA CARRASCO <br />or Other Mailing Address <br />319 ROUSH LANE <br />Category Tax Perlod Date of <br />Number Assesement <br />01 Q4I01/2010 03/20/2091 <br />06/30/2010 <br />Amount of Tax <br />200.00 <br />GRAND IS LAND <br />Penalty Interest <br />45.00 I 10.05 <br />NE 68801 <br />Additions Balance of <br />Assessment Due <br />255.05 <br />TOTAL I $ 255.05 <br />I hereby csrtify that the Nebraska DepaRment of Revenue has complied with the revenue laws oi the State of Nebraska n the determination of the ` <br />amount shown to be due, artd the taxpayer has failed to pay the amount due after demand. If this Notice of State Tax Lien is an extension of an <br />effective lien, it serv continue the priority e state's interest in the affected property of the taxpayer. ' <br />8 � Revenue Agent ,�'�9 a 402 471-6067 � <br />sign rep re s Signature Tiee Date Telephone Numbar <br />here e Senior Revenue Agent g�f �// , <br />uthorized Signa ure T�te Date <br />4-asaae�a Rev. z-zoa2 supers�, �ea-�sia �v. �a��s ' <br />� . <br />