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06/15/2012 FRI 13:50 FAX 402 471 4429 UCC SECRETARY OF 5TATE -�y-� Hall �j002/003 <br />� � ' <br />201�04�� <br />- - UCC STL <br />Pes: 1 <br />MCCALLflY SRM E <br />Filed: 06I15/2�12 09:22 AI'M1 <br />�. . : _.. �- <br />(�etiraska-Depactrneni of <br />����E NOTICE OF STATE TAX LIEN <br />�iehruir.�rs: ov <br />Thts NotPce of State Tax Lien is issued by the Nebraska Department of <br />Revenue fo� unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice is hereby given that faxes Including penalties and <br />interest, which are shown below, ar� due from the taxpaye� specffied <br />below and femaio unpaid after demand. These ta�c� constitute a lien <br />in the couniy for real and personal properly belonging to the taxpayer <br />or hereafter acquired. <br />40384950 <br />11284613 <br />�R�ister of Oeeds �Coimty Clerkl XXX XX-3139 <br />06/13/2012 . � �Original [�Cflntinua6on �Corrected HALL <br />BUSINES9 NA�E AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />. SAM E MCCALLAY <br />4870 W US HWY 30 LOT 6 <br />ALDA NE 68810 <br />Category � Tax Pertod � Date oP <br />22 I 2010 � 05l0412011 <br />TOTAI. <br />Amount of Tax <br />525.00 <br />Penalty Interest <br />28.25 30.57 <br />Additlons I Balance of <br />Agsessment Due <br />581.82 <br />581.82 <br />I hereby cerMy �at the Nebraska Departrnert of Rev�ue t� oompfietl wat► tne revenc� �aws ar me sca�e or neorasKa m u,e ae�ermnauw, v� u� <br />amount shown to be due, and tl� �ayer has failed to pay the amount due after demand. If this Notice of State Tax Lien is an ext�tsion of an <br />effedive lien, it se es to oontin� ihe priarity of tlie state's inferest in Ute �ffected properly of the taxpayer. <br />RevenueAgent �� � �— � Z (402)471�712 <br />Slgtl Pre s'ignahue itle . Dats Telephor�e N <br />here ► �°�' Revenue Supervisor �•��• � Z- <br />A orized S9gnatur Title � <br />a.asa-�s�4 Re,r. z•2ooz su�eraeaa <.asa-�s�� aar. �a�� <br />� <br />