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Tax <br />Category <br />Tax Period <br />Date of <br />Amount of Tax <br />Penalty <br />Interest <br />Additions <br />Balance of <br />Number <br />Assessment <br />Assessment Due <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 />Nebraska Identification Number <br />8091374 <br />Lien Serial Number <br />Dale of Lien <br />Business Name <br />Street Address <br />City <br />Aug,14, 2013 12:57PM NE Secretary of State — UCC No.0450 P. 2 <br />1/3 ?7u' <br />21 <br />21 <br />21 <br />21 <br />sign <br />here <br />Lien Type <br />08/09/2013 [g] Original OContinuation <br />BUSINESS NAME AND LOCATION ADDRESS <br />02/03/2013 <br />12/31/2011 <br />Signature <br />hororrvir .7rW vier bM O <br />201306602 <br />REVENUE NOTICE OF STATE TAX LIEN <br />Lien Filed With <br />Zip Coda <br />725.00 <br />©Register of Deeds ❑County Clerk <br />Federal Identification Number <br />47- 0814574 <br />City <br />Revenue Agent <br />Title <br />253.75 <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Social Security Number <br />Corrected <br />County <br />Hall <br />Spouse's Social Security Number <br />NE Svc of Slate Jahn A G.I - ACC AT <br />11 01 1 11 lilt 11 111 1 <br />9913725935 -6 Pis: 1 <br />Filed: 09/ 11 10:37 RI'I <br />TAXPAYER NAME AND MAILING ADDRESS <br />Name <br />REIS CONSTRUCTION, INC. <br />Street or Other Mailing Address <br />4145 MANCHESTER <br />GRAND ISLAND <br />01/01/2012 <br />03/31/2012 <br />04/01/2012 <br />08/30/2012 <br />07/01/2012 <br />09/30/2012 <br />02/03/2013 <br />02/03/2012 <br />02/03/2012 <br />0.00 <br />0.00 <br />0.00 <br />25.00 <br />25.00 <br />25.00 <br />0.00 <br />0.00 <br />0.00 <br />TOTAL <br />46.44 <br />eSr' !r <br />Da <br />Stale <br />NE, <br />Revenue Senior Agent <br />Title Date <br />4-494.1974 Rev, 2.2002 Supersedes 4494 -1914 Rev. 19 -1995 <br />Zip Code <br />68803 <br />1,025.19 <br />25.00 <br />25.00 <br />25.00 <br />$ 1,100.19 <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the Slate of Nebraska In the determination of the <br />amount shown to be due, and the taxpayer has to pay the amount due after demand. If this Notice of State Tax Lien Is an extension of an <br />effective lien, it se Minus the priori state's Interest In the affected property of the taxpayer. <br />402 471 -6067 <br />Telephone Number <br />