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Program T <br />Tex Period <br />Aaaaiw <br />Tax <br />Penalty <br />Interest <br />Coats <br />Total bus <br />Individual <br />2012 <br />0812712013 <br />416.00 <br />104.00 <br />944 <br />529.44 <br />IIIIII <br />Total <br />3829.44 <br />pan, 21. 2014 2:42PM NE Secretary of State — UCC Nu. 2941 P. 3 <br />Oblast" Dsp.rtmuleet <br />REVENUE <br />201400 367 <br />Notice of State Tax Lien <br />This Notice of State lax Lien is issued by the Nebraska <br />Department of Revenue for unpaid taxes administered by the Tax <br />Commissioner. Taxes, including penalties, interest, and costs, <br />which ere shown below, are due from the taxpayer and remain <br />unpaid after demand.These taxes are a lien for all property located <br />In the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this Ilen.ThIs Ilan will expire and <br />become unenforceable 10 years after the data of recording If no <br />continuation statement fa recotded on or prior to the exi3iration of <br />the previous lien or continuation statemenL <br />Nebraekq ID Number <br />47549513 <br />Lien Sena Number <br />11428043 <br />Do d Lien <br />01116/2014 <br />sign <br />here <br />Lien Filed Mb: <br />Regislercf Deeds <br />Den Type: <br />®o <br />Business Name and Location Address <br />County Meet <br />D ccniimnadon <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Federal ID Nombr e <br />Social Secr$ty Number <br />XXX- XX433i4 <br />['Cored <br />T <br />KENNETH R WOOLFORD <br />AMY A WOOLFORD <br />PO BOX 4904 <br />GRAND ISLAND NE 68802 <br />Y6 Sao of lia■. ]ore 0 G.1t - WC SIL <br />I II, <br />I' 11111111 <br />9914729251 -1 �s <br />PLEASE RE ed� "�R11 :23 DM <br />NEBRASKA DEPT OF REVENUE <br />PO BOK 94609 <br />LINCOLN NE 68509 -4609 <br />Spouse's WS Securly Number <br />XXX-XX -3590 <br />County <br />HALL <br />Name and Mailing Address <br />I Certify SW the NOWA DepelmeN1 of AMMO us mi tied e h Yne lade or the gals of Niihned a Nt deremerir9 fns bosom down to be due, <br />and Mel the to , r has to a ply the amount due after demand, This Nike PI Stet Dalian Is an delve fen and some 10 condole 111e priority or <br />the Shoe's intone In the eikcted of Ow wren. Revenue *Lent /r("1 (308)632.1263 <br />Dale Phone <br />Revenue Supervisor <br />TN* ' �, le <br />4.4$4.1$74 RW48.013 mimeo 4B481974 Rev.2,2 04 <br />