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08/24/2011 WSD 14:57 FAX 402 471 4429 UCC SBCRSTARY OF STATS -�-�y Hall <br />1� <br />� • <br />Nebraska Department of <br />�E�'EI��lE <br />www.�evenue.ne.gov <br />we s�c <br />� <br />�� �E <br />� o � � 0 V � � � <br />�003/003 <br />NOTICE �F STATE TAX LIEN <br />This Notice of State Tax Lien is issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice is hereby given that taxes including penalties and <br />interest, which are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These taues constitute a Iten <br />In the county for rea! and personal property belonging to the taxpayer <br />or hereafter acquired. <br />97833932 <br />11160322 <br />�Register of �ecls �Couniy Cledc� XXX-XX-6308 <br />08/23/2011 �Original �Continuabon �Carrected HALL <br />BUSINESS WAME AND LOCATION ADDRESS TAXPAYER NA69E AND HIAILWG ADDRESS <br />RYAIV M BAKER <br />3346 POPLAR DR <br />LAWRENCEVILLE GA 300443323 <br />Category 7ax Pe�iod Date of <br />Number Assessme� <br />22 2007 11l02t2090 <br />Amount of Tax Penalty <br />182.00 9.10 <br />Interest I Addidons <br />34.43 <br />225.53 <br />TOTAL I $ z2s.53 <br />1 hefeby C�tUly tliat [I� NeDleSlCB DEp21tR18►It Ot RevenUE haS WmpG2d with tl1e rev�lue 18W5 Of 1F� 5teC2 Of NedlesKe In tlle tleDemlltta[iQl1 oT Itle <br />amount shrnm to be due, and tha ta�ayer has failed to pay the amaint due after demarxi. If this Notice of Siate Tau Lien is an ext�sion of an <br />effe�tive lien, it serv�s conGnue the priority of the state's iMerest in the affect� praperty af tl�e taxpayer. <br />� ��� Revenue Agent a ' (402)471-5928 <br />S Ig t1 Preparers s�r�adue itle D�a e Tel�hone Number <br />here ► Revenue Supervisor S. z�. I 1 <br />� A rized Signature Title Date <br />4484-7876 Rev. 2-2002 Superaedes 4-494-1974 Rev.10-1995 <br />Belance of <br />Assessment Due <br />i <br />� <br />[ <br />raaea: �/2412011 09:41 plh <br />