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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 Is hereby 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 to <br />or hereafter acquired. <br />Department of <br />of the state of <br />and <br />specified <br />a lien <br />the taxpayer <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Nebraska Identtication Number <br />98051482 <br />Federal IdantlOctlan Number <br />Spouse's Swat Security Nun ear <br />Seria Num <br />11325445 <br />Lien Filed With <br />County Clerk <br />Social Security Number <br />XXX XX - 2069 <br />3 Register of Deeds 0 <br />Dated Lien <br />11/22/2013 <br />- ben Type <br />County <br />I HALL <br />3 Oligin ■ Continuation I Corrected <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />SURDS DUALS <br />803 S NINE STREET APT E <br />GRAND ISLAND NE 68801 <br />Tax <br />Category <br />Number <br />Tax Period <br />Date of <br />Assessment <br />Amount of Tax <br />Penally <br />Interest <br />Addition <br />Balance of <br />Assessment Dee <br />22 <br />2009 <br />07/09/2012 <br />432.00 <br />21.60 <br />70.22 <br />523.82 <br />TOTAL <br />$ 523.82 <br />I hereby oerb v that the Nebraska Department of Reverxue Ins complied with the revenue Iewe of the Shale of Nebraska in the determination of the <br />N ov,26. 2013 1:23PM NE Secretary of State — UCC <br />amount shown to be due, and the <br />effective lien, it ,''- to continue <br />s <br />here ■ <br />4!i J I , • / <br />j1 �'f' <br />has Failed to pay the amount due after demand nits Notice of State Tax Lien is an extension of an <br />priority of the Slate's Interest In the affected properly of the taxpayer. <br />Revenue Agent <br />201309313 <br />Nebraska Department of <br />REVENUE <br />www.rvvenue.ne.gov <br />Audioozed Signature Title <br />Revenue Supervisor <br />N o, 2088 P. 2/2 <br />NE Sic of Sts*o John A Gallo - hCG STL <br />1 1 1111111 <br />i <br />II I l <br />9913726448 -9 Pea: <br />d Fiiled : /2018 10:12 an <br />NOTICE OF STATE TAX LIEN <br />(402)471 -5789 <br />4494-1074 Rrte 2.2002&emeuw4454.1574 Rev. 10-19115 <br />