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Tax <br />Category <br />Number <br />Tax Period <br />Date of <br />Assessment: <br />Amount of Tax <br />Penalty <br />1p teres$ <br />Additions <br />Balance of <br />Assessment Due <br />03/21/2013 THU 15:30 FAX 402 471 4429 UCC SECRETARY OF STATE <br />Nebraska Identification Number <br />Lien Serial Number <br />//i.2220? <br />Date of Lien <br />Business Name <br />Street Address <br />City <br />01 0 5/01 /2011 08/04/2011 <br />05/31/2011 <br />01 <br />01 <br />01 <br />01 <br />here 6 <br />03/14/2013 <br />10734821 <br />uthorized Sign to <br />Lien Filed With <br />Lien Type <br />BUSINESS NAME AND LOCATION ADDRESS <br />Register of Deeds (County Clerk <br />State Zip Code <br />Oa"— <br />0.00 <br />Title <br />Title <br />y.+.. <br />201302225 <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 taxes including penalties and <br />interest, which are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These taxes constitute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter acquired. <br />Hall 12004 /005 <br />NE See of State John R Ga a - UCC STL <br />9913711193 -1 Pee: 1 <br />HOWARD BRIAN K. <br />Filed: 03/21/2013 11:35 AM <br />«braske Dorprwrtunar t or <br />REVENUE Ii UE NOTICE OF STATE TAX LIEN <br />VolioVw r4rv+rnww.r. ay. {r VV <br />Federal Identification *Ober <br />Original ElContinuation 0Corrected <br />Name <br />Senior Revenue Agent <br />Social Secu y Number <br />X� XX -6339 <br />9 <br />BRIAN K. HQWAR <br />TAXPAYER N AND MAILING ADDRESS <br />Street or Other Malting Atdress <br />851$ AVEBUR( CT <br />City : , a <br />JACKSONVIL <br />PLEASE PO NOT WRITE IN THIS SPACE <br />Hall <br />Spouse's Social Security Number <br />State <br />FL. <br />Zip Code <br />32244 <br />01/01/2011 <br />01/31/2011 <br />04/01 /20 <br />04/30/2011 11 >'rro2lv-ri <br />161.48 <br />07/01/2011 <br />08/31/2011 <br />11/01/2010 <br />11/30/2010 <br />11/02/2011 <br />11/02/2011 <br />01/03/2012 <br />�0 A <br />0.00 <br />237.86 <br />25.00 <br />50.00 <br />25.00 <br />Date <br />4404-104 Rev,'? -2002 Supersedes 4-494 4974 Rev. 10 -1995 <br />0.41 <br />202.38 <br />_. 26:79 <br />50.21 <br />288.30 <br />$ 568.09 <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the Stateof 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 State Tax Lien is an extension of an <br />effective lien, it se ontinue the p efti of the state's interest in the affected property of the ayer. <br />0 rl/ ...........c/ Revenue Agent ! ' ,2v< <br />s reparer's Signature <br />402 471 -6067 <br />Telephone Number <br />3- <br />