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Q8(12/2Q11 Fiu 15:03 FAx 402 471 4429 UCC SECRETARY Og STATE �-�y eall <br />� <br />1 <br />� <br />�o�.�aso4s <br />- ��^:�-z�-�- <br />Nebrask� D.epartment of <br />������� <br />w•wvir.revec�u�e:�•e: g.ov <br />�yooa�ooa <br />NOTlCE OF STATE TAX LIEN <br />Th3s Notice of State 7ax Lien is issued by the Nebraska Department of <br />Revenue for unpaid ta�ces pursuant to the revenue laws of the state of <br />Nebraska. Notice is heteby gtven that taxes includtng penafties and <br />fnterest� 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 personal properly belonging to the taxpayer <br />or hereafter acauired. <br />44095448 <br />Lien Seri�al N�nber Uen Fled With Social Security Number Spouse's Sa�al S <br />91159812 �Rec�ister of De�,s []Ca�nty Cledc XXX-XX-2602 <br />Date of Lien Lien Type County <br />08/11/2011 �Original �Contlnuadon [�Corr�ted Hq�� <br />BUSINESS NAhIE AND LOCATION ADDRES& TAXPAYER NAME AND A9AIUNG ADDRESS <br />MICHAEL K HARRIS <br />4359 W CAPITAL AVE <br />GRAND ISLAND NE 68803 <br />Category Tax Pe�fod <br />Number <br />22 2004 <br />22 2005 <br />22 2006 <br />22 2007 <br />22 2008 <br />Date of I Amount at 7ax <br />12/a3/2010 <br />12/03/2010 <br />12/03i207 0 <br />12l03/2U1d <br />12/03/2010 <br />2,565.00 <br />2,533.00 <br />3,054.00 <br />1,83U.00 <br />• 32.00 <br />Penalty <br />641.25 <br />708.25 <br />862.50 <br />510.50 <br />8.00 <br />IMerest I AddlUor►s <br />1 <br />844.77 <br />817.72 <br />343.19 <br />3.72 <br />TOTAL <br />4,215.60 <br />4,Q84.02 <br />4,734.22 <br />2,6B3.69 <br />43.72 <br />15,781.2; <br />i ne�euy cernry tnet ute rvenrasKa Department of Rev�ue has complietl with the revent� laws of the S'tate ot aebrasKa �n tne determurauon or tne <br />amourrt sh�wn to be due, and the ta�ayer F�,s iailed to pay the amount due after demand if this Notice of Sfate Ta�c Lien is an extension of an <br />effective Gen, it serves to cantinue the priority of the state's inte�t in the aifecxed propetty of the taxpayer. <br />� �q,�l �qv�� Revenue Agent $• I I •aDj1 (402)471-5737 <br />sign Preparer' �tle Date elepha�e um er <br />here ► Revenue Supervisor �1 �f�, <br />Authorized Sign Title Date <br />4-484-1974 Rev. 2-2002 Suparaedes 4-48A-1874 Re¢ 1Q-1995 <br />i <br />r t <br />I' <br />Batan�e of <br />