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10/06/2011 T8U 15:02 FAx 402 471 4429 UCC SECRETARY OF STATE �yy �all <br />� <br />1 <br />� <br />�0�10�45G <br />� <br />� ������ <br />���� <br />�ooz/ooz <br />NOTICE OF STATE TAX LIEN <br />This Notice of State Tax Lien (s tssued by the Nebraska Department of <br />Revenue fo� unpatd taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice is hereby given that taxes including penaities 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 personal property belonging to the taxpayer <br />or hereafter ac4uired. <br />9894969 <br />� �� (P �Register of Deeds �County <br />f I.(en Lien 7ype <br />09/09/2011 QO�iglnal �Conanuation <br />BUSINESS NAME AND LOCATION ADDRESS <br />category <br />Number <br />01 <br />21 <br />21 <br />Tax PerfOd I Date of <br />09/30/20Q9 09/09/2011 <br />10/01 /2008 09/09/2011 <br />12/31 /2008 <br />01/01i2QQ9 09/09/2011 <br />09/30/2009 <br />20-583UO30 <br />XXX XX-2504 <br />�correcced I Hail <br />TAXPAYER NAME AND MAIUNG ADDRESS <br />Chong Kim <br />or Other Mailing Address <br />P.O. Box 50851 <br />Amount of Tax � Penalty � Interest � Additions <br />5,015.10 <br />149.98 <br />240.00 <br />920.24 652.22 <br />37.50 18.08 <br />95.00 39.13 <br />TOTAL <br />82609 <br />Balance of <br />Assessment C <br />6,587.56 <br />205.56 <br />374.13 <br />$ 7,167.25 <br />i rin�aoy cxruiy uia[ me iveorasxa uepartmefli of K8V9f1Ue fk'IS COR1pll� WICII t�8 f8V8(IU8 12WS OT f118 5[8t@ OT NBDfdS1C8 UI TI7A GS[BfI111�8tl0� Of th8 <br />amount shown to be due, and the taxpayer has failed to pay the amount due after demand. if this Notice of State Tax Lien is an e�ckension of an <br />effective lien, it serv�e�t6bMinue the priori the state's interest in the affected property of the taxpa�yer. <br />� � 402 471-8067 <br />e Revenue Agent O� a?o <br />sign Prepa�er's Signature Tdle D e Telephona Number <br />here 8� � Senior Revenue Agent / y/ / <br />' orized Signature • ' Title ' ' � • , D� <br />4494-1874 Rev. 2-2002 Supersede� 4-494-1974 Rev.1�1945 <br />;. <br />`` -. <br />V <br />