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- <br />Tare Program <br />Tax period <br />Data of <br />Assessment <br />Tax <br />Penalty <br />interest <br />Corte <br />Total Due <br />Balm <br />04/01/1413 - 06/10/1013 <br />12/02/9813 <br />244.25 <br />.00 <br />1$.06 <br />.53 <br />2a5.21 <br />Sales <br />(Y1 /01/2013 - 09/30/2013 <br />12/02/2013 <br />683.99 <br />68.40 <br />26.19 <br />.00 <br />778.58 <br />Sales <br />10/01/2013 - 12/31/2013 <br />04/01/2014 <br />500.68 <br />50.07 <br />15.40 <br />.00 <br />566.15 <br />Sales <br />01/01/2014 - 03131/2014 <br />17107/2014 <br />74100 <br />148.00 <br />17.27 <br />.00 <br />905.27 <br />Withholding <br />04 /01/2013 - 06/30/2013 <br />11/25/2013 <br />7.73 <br />1.55 <br />.32 <br />.00 <br />9.60 <br />Withholding <br />07/01/2013 - 09/30/2013 <br />11/25/2013 <br />30.97 <br />155 <br />1.19 <br />.00 <br />33.71 <br />Withholding <br />10/01/2013 - 12131/2013 <br />4.0.00 <br />29.00 <br />1.19 <br />.00 <br />70.19 <br />Withholding <br />01/0112014- 03131/2014 <br />. 12/07/2014 <br />12/07/2014 <br />40.00 <br />29.00 <br />.90 <br />.00 <br />69.90 <br />Total <br />2,718.61 <br />This Notice of State Tax Lien IS issued by the Nebraska <br />Department of Revenue for unpaid texas administered by the Tex <br />commissioner. Taxes, including penalties, interest, end cow, <br />rrhioh are whvr+n behove, aro duo from the taxpayer and remain <br />unpaid attar demand.These taxes are a lien for all property boated <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this iien.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 statentenL <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />11533463 <br />Federal D Number <br />462588773 <br />Lien aerW Number <br />11591292 <br />tJPn 011eii Willy <br />Swirl Saeuriy Numbai <br />Spoueae Social Secu ( y Nurnbor <br />1/ nespeter of Deeds • Gounly [Heck <br />J <br />Dale d tarn <br />January 29, 2015 <br />Lien Type: <br />Counts <br />BALL <br />•.4 Driginat 0 Gommmpon <br />■ corseted <br />Feb. 11. 2015 2 :34PM NE Secretary of State - UCC <br />Nebreeka Oepenni i o <br />R EVENU E <br />sign <br />here <br />t3usinesa Name and Location Addreaa <br />1 es Sonatas <br />AL .- <br />/uN Odrad Signature <br />201500879 <br />Notice of State Tax Lien <br />Revenue Ateat <br />Tnk <br />Revenue Senior Agent <br />Title <br />QTBSTORBS 1.S.0 <br />922 W. 4TH ST. <br />GRAND ISLAND NE 68801 <br />No. 9111 P. 3 <br />iE Sir of Stet. Jan A 6.,e <br />111111 11111 <br />- ucc 571- <br />9s1a7411837•43 Pie: , <br />dd02/11C2/16 12;44 Ph <br />Taxpayer Nance and Mailing Address <br />pats <br />4494.1974 Rat ed013 Supereedef #- 919.1974 Pw. <br />I cerfly that the Nal eslra nepanment of Wen* nes comptod with the laws of Ms State of Nebeadka In determining the arnOual sheen to 4e due, <br />and that the taxpayer has Mated to pay the amoral rue atter demand. This Nodes of Side Tot Lien is an effective hen and sewer le conlitue the priestly of <br />the 8 .., r creel in the affected poapgrly of the taiwayer. <br />