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08/10/2012 FRi 14:47 FAx 402 471 4429 UCC SECRI3TARY OF STATS ��� Hall <br />i� <br />� <br />2p12066 <br />Nfi See <br />99126 <br />GRRND <br />Filed: <br />�003/004 <br />C STL <br />:1 <br />ID T <br />�ehrssko E7ryre►�rta�errt i� <br />���� NOTICE OF STATE TAX LIEN <br />W W W./v►Vl�thasr.tsr.00V <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 />Nebraska. Notice is hereby given that taxos including penalties and <br />interest� which are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These taues constitute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter acauired. <br />8239665 <br />�f � �' ,t� �Reglster of Deeds �C <br />: of Lien Lien Type <br />08/06/2012 QOriginal []Continuation <br />BUSINESS NAME AND LOCATION ADDRESS <br />Category Tax Period Date of <br />Number Assessmerrt <br />Q � 04/01/2011 07�06�2011 <br />04/30/2011 <br />01 05/01 /2011 09/06/2091 <br />05/31 /2011 <br />06/01/2011 <br />01 07/31 /2011 09/06/2019 <br />Q � 08/01/2011 12J01/2011 <br />09/30/2011 <br />� � 10/01 /2011 03/01/2012 <br />12/31 /2011 <br />Amount of Tax <br />0.00 <br />4,945.76 <br />7,991 _ 14 <br />8,873.48 <br />14,453.08 <br />39-1964386 <br />�conected I Hall <br />TAXPAYER NAME AidD MAILING ADDRESS <br />B <br />Grand Island Liquor Mart and Tobacco Row L.L.C. <br />t or Other Mai ing Addreas <br />710 N. Diers Ave. Suite L. <br />State Zip Code <br />Grand Island Ne. 68803 <br />Penalty interest Addidons Balance of <br />380.53 14.07 100.00 <br />0.00 276.42 <br />967.53 397.67 100.00 <br />887.35 365.65 <br />1,445.30 446.67 <br />TOTAL <br />Assessment Due <br />494.60 <br />5,222.18 <br />9,456.34 <br />10,126.48 <br />16,345.05 <br />$ 41,644.65 <br />•��`�o�y �����r u�• ���II �•�����a �aNa�u��Crn vr Rsvenue nas compnea wrtn [ne revenue �aws of tne 5tate of Nebraska in the determination of the <br />amount shown to be due, and the taxpayer has failed to pay the amount due after demand. If this Notice of 5tate Tax Lien is an eMension of an <br />effective lien, it serve continue the prio ' e state's interest in the affected property of the taxpayer. <br />e ` Revenue Agent g dr �aig 402 471-6067 <br />sign rep rer's Signature 7itle Date Telephone Number <br />here e i c- Senior Revenue Agent ,� �9 /.�L, <br />'Aut � r ze '$ignature Title Oate <br />a�sa-�sia rtev. 2-2002 SuPer�des a-asa-ts�n Rev, �atisss <br />� <br />i <br />I <br />i <br />� <br />I <br />i <br />� <br />