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This Notice of State Tax Lien is issued by the Nebraska Revenue for unpaid taxes pursuant to the revenue laws Nebraska. Notice is hereby given that taxes Including penalties interest, which are shown below, are due from the taxpayer below and remain unpaid after demand. These taxes constitute In the county for real and personal property belonging or hereafter acquired. Department of of the state of and specified a lien to the taxpayer PLEASE DO NOT WRITE IN THIS SPACE Nebraska Identification Number 16993499 Federal Identifica Number U Number 942380107 Lien NRe Fled WE County Clerk Social Semi ty Number XXX -XX -9276 Spouses Soda! Secuily Number Deeds ■ Date of lien 07/03/1995 BUSINESS NAME AND LOCATION Lien Type []Corrected TAXPAYER Corny HALL NAME AND MAILING ADDRESS 111 Original G Continuation ADDRESS HAMMRICHNERNON D RR3 BOX 176 CHILLICOTHE MO 64601 Tax Category Number Tax Period Date of Assessment Amount of Tax Penalty Interest - Additions Balance of Assessment Due 22 1988 08/18/1994 1,177,00 294.25 830.35 ++ 2,301.60 TOTAL S 2,301.60 I hereby . • F amount shown that the -, :. to be due. and the ,. Deparbnent . tam here Reveres hoe complied Wed to rim Ito Immure A the revenue laws d the Stem of Nebraska in the deterrem tiara of the to attar : .oared K e,;. au.,aa.,e.0 clot. T,. 1 Lem I. e., e.4....s:.... - Nov, 20. 2013 1:26PM NE Secretary of State — UCC 1 .3 - effective hen, d sign here O. stregue 201303184 Nebraska Department of lime the priority of the state's Interest In the effected property of the taxpayer. Revenue Agent The Cry See a-ac{-ved Revenue Supervisor Title Date SEE ATTACHMENTS • No. 1997 P. 2 sob. . UCC 5CON �I i 89 13728177 -4 IN1RICH VERNON D Pya; 2 Flied: 11/20/2013 10;22 RN REVENUE NOTICE OF STATE TAX LIEN www.revenue.ne.gov occo- (402)471 -5928 Telephone Number v41∎44 14 RIK 2- 20023uperAdes 4491 -111/1 Net 11-1006