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Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total The <br />Sales <br />01/01/2014_- 01/31/2014 <br />08/01/2014 <br />.00 <br />73.03 <br />8.24 <br />.00 <br />81.27 <br />Sales <br />12/01/2013 - 12/31/2013 <br />08/01/2014 <br />.00 <br />.00 <br />9.71 <br />.00 <br />9.71 <br />Sales <br />03/01/2014 - 03/31/2014 <br />10/01/2014 <br />.00 <br />67.30 <br />9.02 <br />.00 <br />76.32 <br />Sales <br />04101/2014 - 04/30/2014 <br />10/01/2014 <br />244.42 <br />70.66 <br />8.44 <br />.00 <br />323.52 <br />Sales <br />02/01/2014.02/2812014 <br />10/01/2014 <br />_ .00 <br />66.4 <br />_ 10.35 <br />.00 <br />76.83 <br />Total <br />567,65 <br />This Notice of State Tax Llen 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 are 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 end rights to property owned by the taxpayer -or <br />acquired before the expiration of this lien. This lien will expire and <br />become unenforceable 10 years after the date of recording It no <br />continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement, <br />PLEASE 00 NOT WRITE INTHeS SPADE <br />Nebraska 10 Number <br />9663606 <br />r'eoeet 10 wear <br />470835635 <br />Lien Serial Number <br />11489997 <br />Lien Fled With: <br />Social Security Number <br />Jt t7i ax..0043 <br />Spouse's Social Security Number <br />i'7 Register d Deeds ■ County Clerks <br />Dale of Lien <br />November 5, 2014 <br />Lien lype: <br />CICOnecled <br />County . <br />BALL <br />►;l DHOW ❑ Oonanuaton <br />Nov. 2CL 2014 3:29PM NE Secretary of State — UCC No, 7803 P. 6 <br />REVENUE <br />sign <br />here <br />Business Name and Location Address <br />Signature <br />menses Ignature <br />201407351 <br />Notice of State Tax Lien <br />Taxpayer Name and Mailing Address <br />DIANE SPAULDING <br />PO sox 5766 <br />GRAND ISLAND NE 68802 <br />id env K S i4e John A Gale • UCC sn <br />0914744916-0 Pee: 1 <br />Sibil _DING Die <br />Filed: 11!20/2014 10 :Z2 RA <br />1 efrU iy Thai the Nebraska Department d Revenue he complied with Si. taws of the Si 1at of Nebraska in determining the amount shown to be W. <br />and that the Wipayer hiss fated to pay amount due Bilee demand The Notice of Stets Tee Lien le an sgedee ten and serves lo otxnunue the po lo*ry of <br />the Sta . rent r he etedetl 7 of fie taxpayer. <br />Ar . _ ..__ <br />Reveam apt 11/10/2014 402 -471 -6067 <br />Tide Due Philtre Number <br />Revenue Senior Agent <br />Title Dale <br />4096.11174 Rev. e,sa13 supersedes 4.919.11174 Mee. <br />