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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 />10/01/2013 - 12131/2013 <br />02/08/2015 <br />.00 <br />25.00 <br />.00 <br />.00 <br />25.00 <br />Sales <br />07/0112013 - 09130/2013 <br />02108/2015 <br />.00 <br />25.00 <br />.00 <br />.00 <br />25,00 <br />----- Total <br />50,00 <br />This Notice of State Tax Uen Is Issued by the Nebraska <br />Department of Revenue for unpaid farces 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.Theee taxes area 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 lten.This Ilen 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 atatsment, <br />PLEASE 00 NW IN THIS SPACE <br />Nebraska 10 Number <br />9437910 <br />Federal ID Number <br />113744320 <br />Lien Serial Number <br />11592319 <br />Lien Ftad Wltk <br />50:401 Securay Number <br />1,X)4923 <br />Spouse's Social Security Number <br />1'1 Register of Deeds ■ County Clerk <br />Del6 at Lien <br />April 16, 2015 <br />Lien Type: <br />County <br />HALL <br />Ill Original • Conanundon <br />• Corrected <br />Apr,23, 2015 3:30PM NE Secretary of State — UCC <br />Nebraska Deemsere of <br />REVENUE <br />Sign <br />hop:, <br />Business Name and Location Address <br />Slpnalura <br />201502539 <br />Notice of State Tax Lien <br />Revenue A tent <br />Tab <br />Revenue Senior Agent <br />TN% <br />Taxpayer Name and Melling Address <br />Ti ENDEL FETTIG <br />1004 S VINE <br />GRAND ISLAND NE 68801 <br />c: , )Seri P, 2/4 <br />9915752847 -1 Pea: <br />Pied 642016 as. as 1 <br />I badly that the Nebraska Department el Revenue Me COMM with file !awe of the State of Nebraska in determining the amount shown to be due. <br />aria slat 1 hen tal51 Io pay 100 a ootnand, This Notice of Stele Tax Lien le an elective lien and serves b mono the priolly of <br />the root In Iho elkdod . s laapayer. <br />04 /17/2015 402-471-0(f22 <br />QM* <br />4 - 1974 Rev. •4e15 aup,1 1 . 444041174 RIAU 02 <br />