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Program Tax Period Asxassmenl Tax Penalty interest Costa Total Due Individual 2012 06/04/2014 4,867.72 1,472.00 360.28 8,700.00 . Total $6,700.00 Jul.16. 201 2:33FM NE Secretary of State — UCC Nebraska Deparonenr of REVENUE This Notice of State Tax Llen Is Issued by the Nebraska Department of Revenue for unpaid taxes administered by the Tax Commissioner. Taxes, Including penalties, interest, and costs, which are shown below, are due from the taxpayer and remain unpaid after demand.These taxes are a lien for all property located in the county and rights to property owned by the taxpayer or acquired before the expiration of this lien. This lien will expire and become unenforceable 10 years after the date of recording If no continuation statement is recorded on or prior to the expiration of the previous lien or continuation statement. Nebraska ID Number 22217908 Lien Serial Number 11554504 Lien Piled With: © Register of Deeds ❑ County Clerk Date of lien Uen Type: 07/14/2015 (KI Original ❑ contlnuadon Business Name and Location Address u •rir:edSignature Notice of State Tax Lien Federal ID Number KEVIN B DARLING 710 DEAN STREET GRAND ISLAND NE 68801 Revenue Agent role Revenue Su t ervisor Tale Nc NE SEE of Stat PLEASE DO NOT WRITE IN THIS SPACE 1F,27 JOIM N 0.1 9915757871 -7 Pys: 1 DRRLING KEVIN 2 Filed: 07/16/2016 01 :19 Pit Soda) Security Number Spouse's Social Security Number )0X -XX -3262 County ['Corroded HALL Taxpayer Nance and Mailing Address I certify mat the Nebraska Department of Revenue has complied with the laws of the Slate of Nebraska in delemuning the amount ahovin to be due, and that t taxpayer has failed to pay the amount due slier demand. This Notice of State Tax Uen is an effective Gen and serves to continue the priority of the Ste greet in the - led property of the taxpayer. 4 LL 5TL 07/14/2015 (402)471 -6043 Dale Phone Number 07/1412015 bate 4- 494 -197d Rev, 6-2015 Supersedes 4 -049 -1074 Rer.2.2002