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Program <br />Tax Period <br />Aasea.rmmer>< <br />Aix <br />Penalty <br />Maser <br />Coats <br />Total Due <br />Individual <br />2012 <br />12/1912014 <br />05.00 <br />4.60 <br />5.97 <br />100.17 <br />individual <br />2013 <br />0312012014 <br />219.00 <br />10.05 <br />5.51 <br />229.10 <br />• / <br />. Motel <br />$335.33 <br />Mar, 2 2015 2:20PM NE Secretary of State — UCC <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />ash DIretalant et <br />REVENUE <br />This Notice of Slate Tax Lien ie issued by the Nebraska <br />Department of Revenue for unpaid sexes administered by the Tax <br />Conwnissioner. Taxes, including penalties, inbred, and odste, <br />which we shown below, are due torn the taxpayer and remain <br />unpaid after dernand.These taxes are a lien for oN property hosted <br />In the county and rights to property owned by the taxpayer ar <br />acquired before the expiration of this Hen, This lien will expire and <br />become unenforceable 10 years alter the date of retorting if no <br />continuation statement is recorded on or prior to the expiration of <br />the previous Ian or continuation statement <br />No a lsIDPM W1 <br />46653147 <br />Lion Serial Numbs, <br />11647522 <br />Date of Lan , <br />02/24/2015 <br />sign <br />here <br />Um tilted Wilt: <br />ZI Register of Deeds p Gaudy cunt <br />uen lype: <br />tldltw D ConarWion <br />Business Name and Location Address <br />20150124g <br />Notice of State Tax Lion <br />PLEASE 00 NOT Werra INNS SPACE <br />Federal D Number <br />Sochi Seaway *sober <br />XXX XX -1025 <br />❑ Carreded <br />DEWAYNE SHORT <br />PO bOX 100 <br />DONIPHAN NE 68632 <br />1 <br />951674580-0 l Pee. <br />SHCRT 0212915 ie :se Hrl <br />Spawn Social Seeuda Number <br />Cam <br />HALL v <br />Taxpayer Name and Nailing Addreee <br />No. 9397 P. 2' 2 <br />ee 54 i 1. )0,,,. a n - uct <br />I or Rome hea compiled wilt the t e at he debar Wheelie in determining the amount shovel to be due, <br />and l d the '' • t . - , • re due sitar demand Tiia Nolo el Slate Tar List is an iIhat a in end WNW q 091101$ 1114 pdaey at <br />�.I Revenue Agent <br />02/2412015 (301)632 - 1210 <br />Tile Oats Phone Number <br />Revenue Supervisor 02/24/2015 <br />Date <br />4-494-1174 Rev x,2013 s spas 4- 9e1-1974 Freak-MU <br />.Tr <br />