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07/LO/2012 TUE 14:49 FAX 402 471 4429 UCC SECRETARY OF STATE �~~ 8a11 <br />�� <br />_�v� <br />2012Q5648 <br />�b� ���� <br />����� <br />'�V�.we..r.,..t�,v,o.. se..L�o,r <br />�1o0z/oo3 <br />NOTICE OF STATE TAX LIEN <br />This Notice of State Tax Lien is issued by the Nebraska D�partment of <br />Revenue for unpaid �uces pursuant to the revenue laws of the state of <br />Nebraska. Notice is hereby given that taxes including penalties and <br />interest, which are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These tanes constitute a lien <br />in the aounty for real and personal property belonging to the taxpayer <br />or hereafter acaulred. <br />11123281 <br />45-3667412 <br />/�,�� 7�"„� 8 � Register of Deeds �County Clerk XXX-XX-2482 <br />of Lien Uen Type County <br />07/05/2012 Qoriginal []Continuation �Corrected Hall <br />BUSINES8 N AME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Category <br />Number <br />01 <br />01 <br />01 <br />01 <br />7ax Period 1 Date of <br />12/31 /2011 03/05/2012 <br />01/01/2012 03/01/2012 <br />01/31/2012 <br />02/01/2012 04/02/2012 <br />02/29/2012 <br />03/01/2012 05/01/2012 <br />03/31/2012 <br />Amount of Tax <br />621.07 <br />547.63 <br />482.20 <br />575.62 <br />Gerald Myers <br />t or Other Mailing Address <br />3427 Deann Rd 9 <br />Grand Island <br />Penalty Interest <br />Ne. <br />Addidons <br />62.11 14.21 20.00 <br />54.76 10.20 <br />48.22 7.07 <br />57.56 5.99 <br />TOTAL <br />68801 <br />Balance of <br />:essment Due <br />717.39 <br />612.59 <br />537.49 <br />639.17 <br />$ 2,506.64 <br />��icicuy ac�uiy u��� uiv ��nura�Ka ueparunen[ or rcevenue nas comp��ea wRn tne ravenue laws ot the 5tate of NebrasKa in me detefmination of the <br />amount shown to be due, and the ta�cpayer has failed to pay the amount due efter demand. If this Notice of State Tax Lien is an extension of an � <br />effective.lien, it serve o continue the prior' r the state's interest in the affected property of the taxpayer <br />8 ' RevenueAgent 7'/�/���� 402 471-60 <br />sign repare s Sigaature Title Date Telephone Number <br />here e � F���-•�''� � Senior Revenue Agent �- �!� <br />,Autho�S�gnature TrUe Date <br />4-084-1974 Rev. 2-2062 Supetsedes 4�494-1974 Rev. 70-1985 t <br />1� ! <br />