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05/11/2012 FRI 15:17 FAX 4p2 471 4429 UCC SSCRETARY OF STATE �y� �all <br />� � <br />201203'�93 <br />� <br />1� seo <br />f�ooz/oo3 <br />PHILLIP L. <br />; 05/11/2012 0H:49 HM <br />�6abTaske a�.pr��ir�arrt+od <br />�'���E NOTiCE OF STATE TAX LIEN <br />wrwr�+v.r�vwcsvtwe..+�, yw <br />PLEASE DO NOT WRITE IN THIS SPACE <br />This Notice of Stato Tax Lien is issueci by the Nebraska Departrnent of <br />Revenue.for unpald taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice is hereby given that taxes tncluding penaltles and <br />interest, which are shown below, are due from the taxpayer specified <br />.belo.w and remain unpaid.after demand. These taxes constitute.a.lien <br />in the county for real and personal propertyr belongtng to the taxpayer <br />or hereafter acquired. <br />8300461 <br />Category <br />�Numbe� <br />21 <br />21 <br />47-0826027 <br />aRegfster of Deeds �County Cle�k XXX <br />Lien Type County <br />05/05/2012 QX Original []Continuation []Cwrected Hall <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAIUNG ADDRESS <br />7ax Period � Date of <br />" "" "`""" 08i17i2010 <br />12/31/2009 <br />01 /01 /2010 08/23/2011 <br />12/31/2010 <br />Amount of Tax <br />40.18 <br />470.00 <br />� <br />Phillip L. Watts <br />t or Other Mailing Address <br />P.O. Box 235 <br />sr�c� <br />Wood River Ne. <br />Penalty Interest Addltions <br />93.75 30.03 <br />117.50 29.63 <br />68883 <br />Balance of <br />sessment Due <br />163.96 <br />617.13 <br />TOTAL I $ 781.09 <br />amount showc� to be <br />effective lien, it serv <br />e o <br />Slgll Prepai <br />here 6 ,� <br />ska Deparbnent of Revenue has complied with the revenue iaws of [ne s�ate or rveoras►ca m u�e aewrm�nanvn vr mn <br />the taxpayer has ' ed to pay the amount due after demand. if this Notice of State Tax Lien is an extension of an <br />nue the prio ' f e state's interest in khe affected prcparty of the taxpayer. <br />O � Revenue Agent s°' � p/ 402 471-6067 <br />iture Tltle D e Telephone Number <br />� ° Senior Revenue Agent �� � � � � L— <br />atura Tida Date <br />4-q94-1974 Rev. 2-2002 Supersedea 4�99-1974 Rev.10.7885 <br />\�/ <br />