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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 I <br />Assessment <br />_ <br />Aaseaenrent Due <br />City <br />Jan.31, 2014 3:33PM NE Secretary of State — UCC N0:3142 <br />Thie 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 Tien <br />In the county for real and personal property belonging to the taxpayer <br />or hereafter ac uired. <br />Nabraska ant' ca on Number <br />10694269 <br />Lien Serial Number <br />Street Address <br />Lien Piled With <br />Data of Lien Lien Type County <br />12/02/2013 [A Original [Continuation °Corrected HALL <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Businese Nerne 'blame <br />State Zip Code <br />1/1/2011- <br />12/31 /2011 <br />111/2012- <br />12/31/2012 <br />08/07/2012 <br />08/08/2013 <br />790.00 <br />990.00 <br />168,00 <br />198.00 <br />69.26 <br />25.71 <br />q1 <br />01 <br />01 <br />111/2010- 08/23/2011 • 795.00 <br />12/314010 <br />I hereby cart that the Nebraska Depe nt of Revenue as comp) with the revenue laws of a State of Nebraska in the determination of the <br />amount shown to be due, and the taxpayer has railed to pay the amount due after demand. If this Notice of State Tax Lien Is an extensbn of an <br />effective lien, it serves lo continue the priority of the state's interest in the affected property of the taxpayer. <br />s <br />here 0 <br />201400 <br />iE &.& .1.11.4s bsl• • UGC STL <br />X 11 � <br />'II I <br />991470655-43 Pea: 1 <br />MALONE MICHAEL <br />Ftlnd: 01f3112014 01t64 PM <br />REVENUE NOTICE OF STATE TAX LIEN <br />®Ra of Deeds County Clerk <br />ederal /den 'cation Number <br />2721188/14 <br />MICHAEL MALONE <br />Street or Other Mailing Address <br />408 W KOENIG <br />City <br />GRAND ISLAND <br />159.00 <br />Revenue Senior Agent 1l <br />Title <br />Revenue Senior Agent <br />Title <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Social Security Number <br />xxx - xx - 8795 <br />Spouse's Social Security Number <br />98,84 <br />/_.3 <br />State <br />NE <br />Zip Code <br />68801 <br />1,062.84 <br />1,007.26 <br />1,213.71 <br />$ 3,273.81 <br />402 471 -5709 <br />Telep 570/Wig <br />Number <br />D a W, " <br />4-494-1674 Rev. 2 -2002 8uperssdes 4. 4944974 Ray,1O.1996 <br />