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06/21/2012 T8U 13:44 FAx 402 471 4429 UCC SECRETARY OF STATE -+�+y 8a11 r �0�:20502� � Kathy A Henderson t or Other Mailing Address PO Box 30095 s�te ---- �„ aKtbrsak�. �e�►��a �a� �i�'E��E w ww .r ��ns n c.a r. �.stsv' NOTICE 4F STATE TAX LIEN Thfs Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuar�t to the revenue laws of the state of Nebraska. Notice is hereby given that taues including penalties and interest, which are shown 6elow� are due from the taxpayer specified below and remain unpaid after demand. These ta�ces consfitute a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. Listed below 120060277 �Register of Deeds []couMy c�erk �ooc-�oc-8312 Lien Type ounty 07/31/2006 QX Original �Cor�inuadon [�Conected HALL BUSINESS NAME AND LpCATION ADDRESS TAXPAYER IVAME AND MAILING ADDRESS I Category Tax Pe�iod Date of Number Assessmerrt 1-9659 �0/13/05 thru 07/05/2006 12/31/2005 1-96594631Q/26/05 thru 07/05/2006 12/31/2005 1-9659501 10/13/05 thru 07/05/2006 12/31/2005 1-965949 �0/13/05 thru 07/05/2006 12/31/2005 1-9670351 11/14/05 thru 07/08/2006 12/31/2005 1-9659471 10/15/05 thru 07/05/2006 12/31/2005 Amount of Tax 3,868.38 10,752.54 5,550.48 3,354.38 3,591.60 0.00 [�002/002 Lincoln NE 68503 Penalty Interest Additlons Balance of 386.84 1,075.25 550.05 335.44 359.16 2.94 118.91 330.53 170.62 103.11 110.40 2.27 TOTAL Assessmerrt Due 4,374.13 12,158.32 6,271.15 3,792.93 4,061.16 5.29 $ 30,662.90 ��rrrtluy ��u�y a�a< <na �veorasrca vepa�unenc or rcevenue nas compuen witn tne revenue laws of the 5tate of NebrasKa in the determinetion of the amount shown to be due, and the ta�cpayer has failed to pay the amount due after demand. If this No6ce of State Tax Lien is an extensfon of an effeGive 11en, it s�rve e� conti �e the pr rity of the state's interesf in the efiected property of the taxpayer, � Revenue Senior Agent -—, ` 402 595-2067 sign rep rer's Signature �tle Da e elephone Number here Revenue SeniorAgent 6•.7/- /L �� utho Si nature TiHe p�@ a�sa-�gra Re,�. z-zaoz s�er�d�4asa-�s�4 �r. �a�s� ; ;