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07/20/z012 FRI 14:14 <br />/ 1 <br />FAX 402 471 4429 UCC SECRETARY OF STATE y~~ &all <br />2�120�969 <br />f�ooz/oo2 <br />� <br />Nebraska Department of ' <br />����E NOTICE OF STATE Tt4X LIEN <br />www.revenue.ne.gov <br />This Notice of State Tax Lien is issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Ne6raska. Notice is hereby gnren that taxes including penalties and <br />interes� which are shown below, ar� due f�om the taxpayer speclfled <br />befow and remain unpaid after demand. These taxes const(tute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter acQUired. <br />36330981 <br />11289587 <br />�( Register of l�eds []Cou►tty Cle�cl XXX-XX-7�47 y XXX-XX-7020 <br />07/19�Z012 I �Original �Contirniaaan <br />BUSiNE5S NAME AND I�CATION ADDRES3 —� <br />Category Ta�c Period Date oF <br />Number Asseseme� <br />22 2007 09/28/2010 <br />Amount of Tax <br />194.00 <br />❑�� I HALL <br />TAXPAYER NAME AND MA{LfMG ADDRESS <br />JEFFREY M REIS <br />HEATHER E REIS <br />4145 MAPICHESTER ROAD <br />GRAND ISLAND {dE 66803 <br />Penalty � Interest � Add�lons <br />52.45 I 129.04 <br />Balenca of <br />375.49 <br />� <br />t� <br />TOTAL f $ 375.49 <br />t hereny cermy tnat tne IVenraslca �epartrnent of Revenue has camplied with tne revernre ►aws ot me state or rvenrasKa m me aeTemunanon or ma <br />amount stwwn to be due, and tt� ta�ayer has faited to �y the amuunt due after demar�d. lf this t�trce of 5tate T�c Lien is an extension of an <br />effec�ve 8en �rve�s to conGttu� priaity of the state's interest in the affected properly of the tazpayer. <br />�'I /1� <br />� %/ �7� RevenueAgent �— — � (40Z)471�043 <br />sign pare gnahue e Date Telephone umber <br />here ► -- Revenue Supenrisor 7. i`f r i Z,._ <br />raed Signadue Title qate <br />4-484-1874 Rev. 2-2002 Supersedes 4494-1974 R9v.10-1995 <br />\, <br />�� <br />� <br />, <br />