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Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Sales <br />08/01/2012 - 08/31/2012 <br />10101/2012 <br />.QO <br />.00 <br />4.45 <br />.00 <br />4.45 <br />Sales <br />10/01/2012 - 10131/2012 <br />12/03/2012 <br />.00 <br />25.00 <br />2.11 <br />.00 <br />27.11 <br />Sales <br />09/01/2012 - 09/30/2012 <br />01/02/2013 <br />.00 <br />25.00 <br />.76 <br />.00 <br />25.76 <br />Sales <br />11/01/2012 - 12/31/2012 <br />05/01/2013 <br />5.00 <br />50.00 <br />2.36 <br />20.00 <br />77.36 <br />Sales <br />01/01/2013 - 01/31/2013 <br />061032013 <br />.00 <br />25.00 <br />.08 <br />.00 <br />25.08 <br />Sales <br />03/01/2013 - 04/302013 <br />06/03/2013 <br />.00 <br />50.00 <br />.24 <br />.00 <br />50.24 <br />Sales <br />05/01/2013 - 05/31/2013 <br />10/01/2013 <br />223.26 <br />25.00 <br />8,22 <br />.00 <br />256.48 <br />Sales <br />06/01/2013 - 06/30/2013 <br />10/01/2013 <br />208.98 <br />25.00 <br />7,18 <br />.00 <br />241.16 <br />Sales <br />07/01/2013 - 07/31/2013 <br />10/01/2013 <br />241.13 <br />25.00 <br />7.62 <br />.00 <br />273.75 <br />Sales <br />08/01/2013 - 08/31/2013 <br />1001/2013 <br />34.96 <br />25.00 <br />1.04 <br />.00 <br />61.00 <br />Withholding <br />07/01/2013 - 09/30/2013 <br />05/09/2014 <br />.00 <br />30.00 <br />1.61 <br />.00 <br />31.61 <br />Total <br />1,074.00 <br />Sep,29, 2014 3 :31PM NE Secretary of State - UCC No, 6967 P. 5/5 <br />NsbresksOa0erbnent W <br />REVENUE <br />This Notice of State Tax Lien la issued by the Nebraska <br />Department of Revenue for unpaid taxes administered by the Tax <br />Commissioner. Taxes, including penalties, Interest, and coels, <br />which are shown below, are due from the taxpayer and remain <br />unpaid after demend.These taxes are a lien for all property located <br />In the county and rights to property owned by the taxpayer or <br />acquired belore the expiration of this IIen.Thts lien will expire and <br />become unenforceable 10 yews after the date of recording if no <br />continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />Nebraska ID Wumbar <br />11242787 <br />Lien Serial Water <br />11489126 <br />Lien Fled WlI <br />IXI Register of Deeds <br />u Gamy ow* <br />• its o Lion Lien Type; <br />September 11, 2014 no original ❑comInuation <br />Business Name and Location Address <br />1 eervay that Ins Nebraska Department of Revenue has complied with the laws of the SING of Nebraeke in determining the amount shown to be due, <br />ens that the la,eayer nas tailed to pay the amount des altar demand. This Notice of Stale Talc Lien is an effective ten and senate lo continue Ica priority of <br />the Start in the affected pry y of Me taxpayer. <br />Notice of State Tax Lien <br />sign F ssgrea � � <br />here � . h j <br />Aura:pe a Signature <br />Revenue Agent <br />Title <br />Rcveuuc Senior Agent <br />Title <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Federal 0 camber <br />454831092 <br />Socid See" Number <br />a Corrected <br />11111111111 <br />9014742626 -7 Pga: 1 <br />BsILUO LC <br />Filed; L 05/a912e14 10:59 lit <br />201406199 <br />Powell sopri Security Number <br />Comfy <br />HALL <br />T r Name and mail) .. Address <br />BALDO LLC <br />14036 EDDY ST <br />GRAND ISLAND NE 68801 <br />09/24/2014 492-471 -6067 <br />Dale Phone Number <br />Dos <br />4444.1074 Ran 0,:015 assented's 4949-79 raw. <br />