DM-2013-00026.tif Printed Field Orders
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Dispatch` Group: I.INEI'RNZ F`i ettl Activity Tds_76673U0904
FA Type: REMOVSVC
Order Init: Remove Service and /or Meter Initiated on 12/28/2012 08:47:50 BY X5541 NANCY A GODDARD
Instructions:
Service Date Req: Dec/28/2012
Account: Create Dttm: 12/28/2012 8:47 AM
Customer Name:
Address: 739 N 11 ST, BLAIR, NE, 68008 -1333
Primary Phone:
Alternate Phone:
Landlord Information
Landlord: Revert Type:
LL Primary Phone: LL Alternate Phone:
Service Point / Premise Information
SP Id: 7667300040 SP Type Cd: RS Premise Id: 6667300040
SP Use Code: Rate: Prem Key Id:
SP Source Status: D Cir: 363 Premise Type: None
Transformer Nbr: 8NN14933 Mtr at SP: ON Disc Loc: Pedestal
MR Cy: 18 SP Loc Detail: OPs Area: Blair
Route: 1862 Seq: 1,233 MR Instructions:
Meter Location: OUTSIDE ON WEST Volt: 120/240 SP COnfig: 120/240/1/3
SIDE
I.,Phase: 1 Wire: 3
Tunr On Date: Tunr Off Date:
Existing E ui ment
ITEM_ID Type Desariptioi 'VT.Rat }a" Mfgr/Moclel" G T,Ra t io:-
Meter Information
f
Mtr Nbr x Serial Nbr Ert Mtr " Phase . , Volt "Wire CL `; . Test,Forth. " Rib , RGl &2=
Amps 'Amps Code4"
47852290 1 ITRON/ 23906548A 240 3 200 30 2S 001
47852290 '
Re Const Reg Reading Read Dttiri Dail TOU Cd UOM Cii R C
Install Meter
CT: CT Ratio: Mtr Const(Bill Mult):
VT: VT Ratio: Turns /Legs(SP):
Mtr Loc: Trans Nbr: ely J 1- 33 REg Id:
Prog K: Mtr Read: Mtr Nbr:
Comments: iSCo�h�c � n c( �� ZS,c s� ef" 3
Work Done By: y p J / '"'' Date: 0 Time:
Dec 28, 2012 1 8:49:57 AM
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TAX.RECEIPT
MARJORIE S HOIER WASHINGTON COUNTY TREASURER
Parcel # 890052563 Roll Year 2012 Receipt No. 2012- 0002080
Legal BC FAIRVIEW HEIGHTS LOT 54 BLK 4 115 Date of Payment: 01/22/2013
PC 5 Type of Tax: REAL
739 N 11TH ST BLA
Tax Due 12/30/2012 TAX DISTRICT 208 Original Tax 2248.24
Delinquent TAX RATE 2.072863 Tax Before Credit 2248.24
1st Half. 05/01/2013 VALUE 112,335 Homestead Credit 0.00
2nd Half 09/01/2013 Late Filing Fee: 0.00
MAR CHECK
PAID BY: RAWLS, MICHAEL D & JULIE Receipt voided until final payment of any check or draft tendered.
Payment FULL
RAWLS, MICHAEL D & JULIE L Installment 2,248.24
Interest 0.00
PO BOX 95 Advertising 0.00
BLAIR, NE 68008 -0000 Penalty 0.00
TOTAL COLLECTED 2,248.24
COMMENTS MF RECEIPT
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Jan, 22. 2013 3:42PM No. 7101 P, 1
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r1RE INSURANCE EXCHANGE, LOS ANGELES, CALIFORNIA
NOTICE OF CANCELLATION
INSURER'S NAIME AND ADDRESS: DATE MAILED:
JULIE RAWLU AND MICHAEL RAWLS 11-30 -2012
PO SOX 95
DUNCAN NE 68534 -0095 CANCELLATION DATE
NOVEMBER 29, 2012
POLICY NUMBER: EFFECTIVE AT-
95280 12:00 NOON StcmdardThne
LOAN NUMBER: 224825929
PROPERTY L0CATION:
139 N 11TH 8T
BFAIR NE [ ,7 68008 1 1 5u 333 My�( F { y({n r
VISA
To pay wllh mdli /4968 (ard, please conlacl
o.00 $0.00 V0,00 Yourdosal,
A8 YOU REQUESTED, WE HAVE CANCELLED YOUR POLICY.
.....mow
ANY REFUND OR INVOICE FOR PREMI17M DUL WILL BE SENT SEPARATELY.
LjBNH2OLDER OR ()TH INTEREST: SERVICE CENTER AI?DMSS:
BANK OF AMERICA NA P.O. SOX 296
SHAWNEE MS, Ke 66201
Ps0 Box 961251
FORT WORTH, TX
16161 -0291
Agent Name: Agent No: Agent Rhone:
MICAH D. BAUGHMAN 12 02 346 (402) 502-2010
2S 4139 11
11-30-2012 AM9701
Jan. 22, 2013 3:42PM No, 7101 P. 2
P.0, SOX 296
SHAWNEE M$, K6 66201
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JULIE & MICHAEL RAWLS
PO BOX 95
DUNCAN PTE 68634 -0095
The below message is applicable to the following Privacy Act States (AZ, [.A, M, IBS, IMN, MT, NV, OR,
VA)
If you have a question regarding this determination, please contact your Farmers agent. If you send us a
written request within 90 business days from the date of mailing this notice, we will respond with the specific
MOWS for tlmis notice, if they are not already included in this mailing.
You have it right to know the specific items of personal and privileged information that supports our
decision, as well as the names and addresses of the sources of that information. You also have a, right to see
and receive copies of documents relating to our action.
If you believe your personal information is incorrect, you may \vrite to us asking us to correct, amend or
delete the disputed information. After we review your request, we will make the appropriate changes, If we
cannot make the changes you request, then you can file a statement outlining why you disagree with our
decision. We will include your statement in our policy file so anyone reviewing your information will have
access to it. In addition, at your request, we will also provide a copy of your statement to anyone who may
have received your information from us in the previous two years.
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A4139102
Date Created WASHINGTON COUNTY TREASURER'S OFFICE Last Update
11/21/20'11 TAX STATEMENT FILE I 11/21/2011
Statement: 2011- 000090ORP Land Value: 19,405 Roll Year 2011/2011
Parcel # : 890052563 GB Loss Source REAL
Mortgage #: Imp Value 92,930 Gross Tax 2,364.62
Owners ID: 2090049 Outbldgs 0 Greenbelt 0.00
District 208 Tot Value 112,335 Homestead 0.00
Tax Rate 2.104964 HS Amount 0 Tax Credit 84.60
UU Tax Cr: 0.00 Taxable 112,335 Taxes Due 2,280.02
Drainage 0.00
RAWLS, MICHAEL D & JULIE L Delinquent Penalty Tax:
Year: 0 Cert Fees 0.00
739 N 11TH ST Advertising: 0.00
BLAIR, NE 68008 -0000 Total Due 2,280.02
Map # BCF- AIR -VI- 4- 54 Tax Paid 2,280.02
Legal BC FAIRVIEW HEIGHTS LOT 54 BLK 4 115 PC 5 Tax Due 0.00
Situs 739 N 11TH'ST BLA Int Due 0.00 j
Notes Total Due 0.00
Page 1 of 3
890052563 2011 / 2011 RAWLS, MICHAEL D & JULIE L 2
Mortgage Information
Loan Number Tax Sale # /Date
Delinquent Report -
Bankruptcy #
Foreclosure Date
Resolution Date
PA &T Class Codes 01 01 01 01 04 01�',
Tax Sale Certificate Data
Certificate # Filing Fees
Purchasers ID # Interest Due
Date Purchased Total Amount
Certificate Type Redemption Date
Maturity Date Redemption #
Principle Redemption Amount
Page 2 of 3
Receipt # Code Pay Date Tax Payment Interest Drainage Total Pay
2011- 0003519 1 04/04/2012 1,140.01 0.00 1,140.01,
2011- 0012787 2 08/07/2012 1,140.01 0.00 1,140.01
890052563 2011 / 2011 RAWLS, MICHAEL D & JULIE L
TIF Fund # Tax Credit Rate 0.0007531 0.00
Gross Taxes Taxes'after HS Tax Credit Net Taxes
Base 0 2,364.62 2,364.62 84.60 2,280.02
Excess 0.00 0.00 0.00
Change Date Change Code Prev Value New Value Value Change Tax Change.'
890052563 REAL Page 3 of 3
SID PRINCIPAL Interest Due PENALTY Ad Due Total Due S
Total 0.00 Statmnt Date /Seq #11/21/2011 5688 0.00