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Tau <br />Proprern <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penaiw <br />Interest <br />Costs <br />Total clue <br />sates <br />02/01/2013 <br />02/28/2013 <br />04/01/2013 <br />0.00 <br />0.00 <br />0.31 <br />0.31 <br />Sales <br />03/01/2013 <br />03/31/2013 <br />05/01 /2013 <br />0.00 <br />0.00 <br />0.61 <br />0<61 <br />sates <br />04/01/201 3 <br />04/30/2013 <br />07/01 /2013 <br />0.00 <br />30.06 <br />0.76 <br />30.82 <br />Sales <br />05101/2013 <br />12/31 /2013 <br />02/03/2014 <br />6,324.87 <br />637.49 <br />129.79 <br />7.092.15 <br />Withholctng <br />04/01/2013 <br />09/30/2013 <br />02/0112014 <br />970.00 <br />266.75 <br />19.92 <br />1,256.67 <br />• <br />Total <br />6,380.56 <br />cfb <br />Jun, 3, 2014 3:29PM NE Secretary of Mate — UCC <br />Nebraska Department of <br />REVENUE <br />This Notice of State Tax Lien is issued by the Nebraska Department of <br />Revenue for unpaid taxes administered by the Tax Commissioner. Taxes, <br />including penalties, interest, and costs, which are shown below, are due <br />from the taxpayer and remain unpaid after demand. These taxes are a <br />Hon for all property located in the county and rights to properly owned by <br />the taxpayer or acquired before the expiration of this lien. This ken wit, <br />expire and become unenforceable 10 years after the data of recording <br />if no continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement <br />Nebresiw umber <br />10669280 <br />Lien Sea Number <br />// <br />Date of Uen <br />05/23/2014 <br />Notice of State Tax Lien <br />Lien Filed Wbth <br />BUSINESS NAME AM) LOCATION ADDRESS <br />201403295 <br />IN Register of Deeds []county Clark <br />Uen Type <br />Weisner Ljccntinualon <br />Rt venue Agent <br />Title <br />Federal ID Number <br />DCOMMted <br />Rtavonua Gmlar Ayorrt <br />Title <br />Tara Blake more <br />2422 W. 16TH St. <br />Grand Island <br />No, 5061 <br />PLEASE DQ NOT WRITE IN THIS SPACE <br />Scanty Number <br />XXX -XX -3427 <br />County <br />Hall <br />TAXPAYER NAME AND MAILING ADDRESS <br />�d / /f <br />Date A� <br />, — of a {.t. J.he C e.l. - IICC STL <br />11 Ill <br />I <br />9914136891 -3 Pee: 1 <br />Fil / Teata14 11 tie cc <br />Spouse'. Social Seanrity Nurh <br />No. <br />I certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska In the determining the amount shown <br />to he due, and that e» tenpeyer hes felled to Fey the amours due aftier denrnd. Thb Nolan 4r State Tat Lien Ia On CrIOO.vm lice end =y <br />to continue the 0; the State's interes l e affected property of the taxpayer. <br />4.151.1911 Aev. 67015 a49 rsedt.4d94 -1574 Am 240e2 <br />68803 <br />402 471 -8067 <br />hane Number <br />