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Tax Program Tax Penod Date of Assessment Tax Penalty Interest Costs Total Due Sales 10/01/2011 - 12/31/2011 07/02/2012 536.34 _ .00 49.81 .00 586.15 • Total 586.15 This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes administered by the Tax Commissioner. Taxes, including penalties, interest, end costs, which are shown below, are due from the taxpayer and remain unpaid after demand. These taxes are a lien for all property located in the county and rights to property owned by the taxpayer or acquired before the expiration of this Item This Ilan will expire and become unenforceable 10 years after the date of recording if no continuation statement is recorded on or prior to the expiration of the previous Ilen or continuation statement. PLEASE DO NOT WRITE IN THIS seAcic . Nabruka ID Number 10440046 Navel ID Number Lien Berlal Number 11488043 Lien Filed With: @ Resister a Deals ❑ Canty clerk Sankt Seedily Number X xC�3754 _ Spume's Social Security Number Piste of Lien July 7, 2014 Lien Yype: County HALL 1 original • continuation • Corrected Jul, 18. 2014 2:35PM NE Secretary of State — 'JC0 No, 5860 P, 2/2 Nebraska uenenmenl of REVENUE Business Name and Location Address 201404407 Notice of State Tax Lien Taxpayer Name and Mullin CHOL T DENG 1201 S LOCUST ST STE E GRAND ISLAND NE 68001 $t Sac vF Slate John A Eta - UGC ATI. III 9914739SB1 -1 Pga: 1 DfiNT CHOL T Ailed: 07/10/2a1a 11:09 PIN Address 1 eerily That the Nebraska Department of Revenue has complied with the taws at the slabs d Nebraska in delexnuining the amount shown to be due, and Ind the taxpayer has lallea to pay ate amount due after demand. rue Nonce or Stele Tax Lien is an olteclive lien and aerwes 10 maw The priority or Me S Ws irnerest In de anected p<ppgny oI the Taxpayer, 402- 4 71 -6467 Phone Number 7 — f �4r Authorized Slonatuw `title Date 4- 494- 1a?apa45- 20135deeeed s 4415-i Pe Pam 1.200