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Tax Program <br />Tax Penod <br />Date of <br />Assessment <br />Tax <br />Penalty <br />interest <br />Costs <br />Total Due <br />Use <br />01/01/2010 - 06130/2014 <br />01/01/2014 - 06/30/2014 <br />07/24/2014 <br />07/24/2014 <br />407.95 <br />1,057.27 <br />350.00 <br />182.19 <br />43.88 <br />20.52 <br />.00 <br />.00 <br />.00 <br />801.83 <br />1,259.98 <br />199.01 <br />Withholding <br />Withbo1dinc_ <br />01/01/2012 - 12/31/2012 <br />07/24/2014 <br />148.71 <br />37.18 <br />13.12 <br />Withholding <br />01/01/2013 - 12/31/2013 <br />07/24/2014 <br />2,384.22 <br />596.06 <br />71.12 <br />.00 <br />3,051.40 <br />Withholding <br />01/01/2010 - 12/31/2010 <br />07/24/2014 <br />14.38 <br />3.60 <br />2.20 <br />.00 <br />20.18 <br />Withholding <br />01/01/2011 - 1213112011 <br />07/24 /2014 <br />1,125.93 <br />281.48 <br />128.48 <br />.00 <br />1,535.89 <br />Total <br />6,868.2.9 <br />This Notice of State Tax Lien is issued by the Nebraska <br />Department of Revenue for unpaid taxes administered by the Tax <br />Commissioner. Taxes, Including penalties, interest, and costa, <br />which are shown below, are due from the taxpayer and remain <br />unpaid alter demand.These taxes are a lien for all property located <br />in the county and 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 if no <br />continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />PLEASE nO NOT WRITE INDUS SPACE <br />Nebraska ID Number <br />10777431 <br />Federal ID Number <br />271059243 <br />Lien !Sufi Number <br />11490421 <br />Lien Filed Wih: <br />RI Flasher of Detdi ❑ Googly Clerk <br />Social Security Number <br />Spouse's Social Seouriy Number <br />Date al lien <br />November 26, 2014 <br />Lien 'Wei <br />Original ❑ Conanuamn <br />exunw <br />HALL <br />• Corrected <br />Dec. 5. 2414 2 :48PM NE Secretary of State — UCC No. 8049 P. 3 <br />►felbraets Depsnmenr of <br />REVENUE <br />Business Name and Location Address <br />sign ,!_/ ---: <br />here P M� <br />e ea Signature <br />horiasd Signature <br />201407662 <br />Notice of State Tax Lien <br />MG v N i1.4e Jelin n Gale . UCC STL <br />9814745591 -7 Pgs: 1 <br />WORMS WIND 0 SOLAR POWER SYSTE <br />Filled; 12/05/2514 09:00 AM <br />Taxpayer Name and Mailing Address _ <br />WORMS WIND & SOLAR POWER SYSTEMS, INC <br />1004 S VINE ST <br />GRAND ISLAND NE 68801 <br />I csrdly mar Me NebruISa Department al Revenue has careened with the laws of era Stale of Nebnaelse in determining the amount shown lo be due. <br />and that the taxpayer naS tailed 10 amount out aver aemana. Thai Nouce of Sate Tax Lein a an effective NOS and serves to continue the priority of <br />the Interest in the afle led p Iyof the mover. <br />Revenue Agent 12/02/2014 402 -471- 60�i7,,,,,„ <br />Title Dale Phana Number <br />Revenue Senior Agent /1 - 4- / V <br />rue Date / <br />4494 - 1074 Rer. 9.2011 Supersedes 4. 049 - 107e Nam ` 9 <br />-174ili <br />