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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 Whereby 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 a , uired. <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 />. <br />Nebraska Identification um <br />16123409 <br />Federal Identification Number <br />Lien Serial Number <br />11394024 <br />Lien Filed With <br />Social Security Number <br />C xdy Clerk XXX -XX -0256 <br />Spouse's Soul Security Number <br />I <br />3 Register of Deeds I <br />Dale of Lien <br />09/04/20137 <br />Lien Type <br />Original I Continuation I Corrected <br />County <br />HALL <br />. <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />LARRY A STOBBE <br />4921 FORT KEARNEY RD <br />GRAND ISLAND NE 68801 -9035 <br />Tax <br />Category <br />Number <br />Tax Period <br />Data of <br />Assessment <br />Amount of Tax <br />Penally <br />Interest <br />Additions <br />Balance of <br />Assessment Due <br />22 <br />2006 <br />12/18/2010 <br />816.00 <br />93.30 <br />349.70 <br />1,259.00 <br />I - _ , curtfy <br />amount shown <br />: Nebraska <br />to be due. and the <br />- <br />Deparvnent of <br />taxpayer has fated <br />Revenue I %= • • , -, <br />m Deer the arrant due <br />, 1 revenue laws <br />afAar demand_ If <br />TOTAL <br />, the State of Nebraska In the , <br />ride Wig of 5Vsatp. Tow I ion k an <br />$ 1,259.00 <br />_ : , , , the <br />&Manaki n ed on . <br />Sep. 10. 2013 2:55PM NE Secretary of State — UCC <br />effective lien, it serves <br />• <br />sign <br />here • <br />201307412 <br />Nebraska Department of <br />the priority ' the state's interest in the affected property of the taxpayer. <br />Revenue Agent <br />Title Data <br />Revenue Supervisor <br />Title <br />4- 194 -1974 Rev. 2-2002 Supersedes 44941974 Rev. 10.199 <br />No.0845 P. 3/3 <br />NE 5r= eR ohm A Yale • utt SYL <br />9913722499 -2 Pee: 1 <br />57088E LARRY A <br />PLEASE RETURN Filed: 09)1eI2013 18 :22 AM <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />REVENUE NOTICE OF STATE TAX LIEN <br />www. reve nue.ne.Oov <br />