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This Notice of State Tax Lien is issued by the Nebraska <br />Revenue for unpaid taxes pursuant to the revenue laws <br />Nebraska. Notice is hereby given that taxes including penalties <br />Interest, which are shown below, are due from the taxpayer <br />below and remain unpaid after demand. These taxes constitute <br />in the county for real and personal property belonging <br />or hereafter acquired. <br />Department of <br />of the state of <br />and <br />specified <br />a lien <br />to the taxpayer <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Nebraska Identification Number <br />36335010 <br />Federal Identification Number <br />Lien Serial Number <br />11312703 <br />Lien Filed With <br />Clerk <br />Social Security Number <br />XXX -XX -9382 <br />Spouse's Social Security Number <br />3 Register of Deeds /County <br />Date of Lien <br />01/07/2013 <br />Lien <br />0Original <br />Type <br />County <br />HALL <br />• Continuation II Corrected <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />JASON D RODER <br />27 VENUS <br />ALDA NE 68810 <br />Tax <br />Category <br />Number <br />Tax Period <br />Date of <br />Assessment <br />Amount of Tax <br />Penalty <br />Interest <br />Additions <br />Balance of <br />Assessment Due <br />22 <br />2008 <br />07/03/2011 <br />342.00 <br />17.10 <br />63.81 <br />422.91 <br />TOTAL <br />$ 422.91 <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in the determination of the <br />01/10/2013 THU 14:33 FAX 402 471 4429 UCC SECRETARY OF STATE <br />amount shown to be due, and the taxpayer has failed to pay the amount due after demand. If this Notice of State Tax Lien is an extension of an <br />effective lien, it serves to continue the the st 's interest in the affected property of the taxpayer. <br />sign ■ P <br />here ■ <br />•1.1 • l :- <br />I A /I.r/i�%/ <br />re <br />..r V <br />Authonzed S uture <br />20130024ri <br />Nebraska Department of <br />REVENUE NOTICE OF STATE TAX LIEN <br />www. re Von ue ne.�oV <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />Title <br />ytiy <br />Hall 12002/002 <br />NE Sec of State John A Gale - UCC ST <br />11111, 1 111 <br />I <br />9913706341 -9 Pgs: 1 <br />RODER JASON D <br />Filed: 01/10/2013 09:55 AM <br />Date <br />4.494.1974 Rev. 2.2002 Supersedes 4-494-1974 Rev. 10 -1995 <br />