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This Notice of State Tax Lien is issued by the Nebraska Department of <br />—Revenue - for - unpaid taxes-pursuant -to the revenue 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 />PLEASE DO NOT WRITE IN THIS SPACE <br />...::: ,_ ........ <br />Nebraska Identification Number <br />47018909 <br />Federal Identification Numb <br />it <br />Lien Serial Number <br />11324884 <br />Lien Filed With <br />3 Register of Deeds II County Clerk <br />Social Security Number <br />XXX -XX 3271 <br />Spouse's Social Security Nlpnber <br />Date of Lien <br />04/01/2013 <br />Lien Type <br />1!4 Original • Continuation II Corrected <br />I <br />gotOY <br />HALL <br />BUSINESS NAME AND LOCATION ADDRESS <br />? TAXPAY ,NAME'AND MAILING ADDRESS <br />STEVE E BRANC <br />309 W HEDDE APT 10 <br />GRAND ISLAND N 6$801 ' , <br />4 <br />t <br />i <br />a <br />Tax <br />Category <br />Number <br />Tax Period <br />Date of <br />Assessment <br />Amount of Tax <br />Penalty <br />hY <br />In 04$l <br />Additions <br />Balance of ; <br />Assessment Due= <br />22 <br />2006 <br />12/02/2011 <br />542.00 <br />135.50 <br />) 8 6.89 <br />864.38 <br />22 <br />2007 <br />12/02/2011 <br />428.00 <br />107:00 <br />115.25 <br />• <br />648.2 <br />22 <br />2008 <br />12/02/2011 <br />647.00 <br />18 01 9 7 <br />1 5.02 <br />952.1 <br />22 <br />2009 <br />12/02/2011 <br />713.00 <br />199.58 <br />1Q, .13' <br />• <br />1,014.71• <br />22 <br />2010 <br />05/24/2011 <br />154.00 <br />7.70 <br />14.36% <br />r <br />,, <br />176.06) <br />OTAL <br />$ 3,656.40 <br />I hereby certify that the Nebraska Department of Revenue has rnmnlixi with rho nouani ho !mum „s th Lo ..r Ma1,...1., ,., ,M., a,.,......:__.:__ _.1,_ <br />04/02/2013 TUE 14:33 FAX 402 471 4429 UCC SECRETARY OF STATE <br />201302666 <br />■ <br />Nebraska Department of <br />REVENUE NOTICE OF STATE TAX LIEN <br />amount shown to be due, and the taxpayer has failed to o y S <br />a�Y pay the amount due after demand If this N tic�t � $tats Tax Lien is an extension of an <br />effective lien, it serves to cont the priority of the state's interest in the affected property of the t <br />rte" <br />Revenue Agent <br />Title <br />Revenue Supervisor ' <br />Authorized Signature Title <br />4 .41 4 s?t <br />Hall 01002 /002 <br />NE Sc e of S!a a John A Gale - UCC STL <br />9913712099 -2 Pgs: 1 <br />BRANCH STEVE E <br />Filed: 04102/2013 12:24 PM <br />$ -2002 Supersedes 4494.1974 Rev. 10.1995 <br />(402)471 -6043 S <br />Telephone Number <br />rhbi <br />Date <br />