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Pry gram <br />Tex Period <br />Tax <br />Penalty <br />Interest <br />Coats <br />Tow Due <br />Individual <br />2013 <br />05/2012014 <br />510.00 <br />34.67 <br />17.10 <br />Total <br />6561.77 <br />Jun, 2. 2015 3:44PM NE Secretary of State — UCC No. 11105 P. 4/4 <br />Nehmen Do mtTnm or <br />REVENUE <br />1 <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 penaItles, Interest, and costs, <br />which are shown below, are due from the taxpayer and remain <br />unpaid after demand.These tease ere a In for ail property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration oI this lien. Thla lien udill 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 Tien or continuation statement. <br />Nebraska iD Number <br />95409831 <br />Lion Serial Number von Filed W h: <br />11552140 NI Rajahs of Deeds ❑ Dainty clerk <br />Data . Lbi UanType <br />05(28/2015 Ofiodo d p cuminuallon <br />Business Name and Location Address <br />sign <br />here <br />201503639 <br />Notice of State Tax Lien <br />T10e <br />PLEASE DO NOT WRITE IN MS SPACE <br />Federal ID Number <br />SocW Soc ily owes <br />y00f XX -3416 <br />OCurrecree <br />MICHAEL J SERRATO <br />2114 W 2ND STREET RI1 202 <br />GRAND ISLAND NE 68803 <br />Revenue Ajient <br />Na a.r rf i1.ta John R Cole - LKC sTL <br />1015755356 --3 Pas: 1 <br />0EARATO MIGNAEl 3 <br />Filed; 116,92/2a15 02167 PM <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />Spouse's Bohai sswrly reseew <br />uny <br />HALL <br />Taxpayer Name and Mailing Address <br />I car* dial du Nobsalca Damtuilnoni of Rums h mptad tath iha iaxa of Iho Stota d Masao o in daIWII* g the *Murk abaft to bo duo, <br />and mai me wpayer ape wow a pay re anoint due slier een0o0. TNS Now of taste rda UM le an Cease ten and NM» o ' 10 conaae the prlepty of <br />AO awlua XI - 01 Me , .,• ar Vro Iwp. W. <br />AI ./ier Ar <br />0512812015 (3081632.1 <br />Ties Delo Phase Number <br />Revenue Supervisor 05128/2015 <br />Dote <br />4a11.1•104 rpr,ea.la sepseee7e 1•5191b74 Aev 2 -2002 <br />