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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 />Withholding <br />07/01/2013 - 09/30/2013 <br />11/12/2013 <br />520,63 <br />31.49 <br />29.23 <br />.00 <br />581.35 <br />Withholding <br />10/01/2014 - 12/31/2014 <br />04/19/2015 <br />1,315.00 <br />197.25 <br />14.59 <br />.00 <br />1,526.84 <br />Withholding <br />07/01/2014 - 09/30/2014 <br />04/19/2015 <br />1,315.00 <br />394.50 <br />24.53 <br />.00 <br />1,734.03 <br />Withholding <br />01/01/2014 - 03/31/2014 <br />04/19/2015 <br />1,315.00 <br />460.25 <br />44,42 <br />.00 <br />1,819.67 <br />Withholding <br />04 /01/2014 - 06/30/2014 <br />04/19/2015 <br />1 - 00 <br />460 <br />34,47 <br />00 <br />1,809.72 <br />Total <br />7,471.61 <br />Jul, 24. 2015 2:21PM NE Secretary of State — UCC <br />Ne brazxa Department of <br />REVENUE <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 penalties, interest, and costs, <br />which are shown below, are due from the taxpayer and remain <br />unpaid after demand,These taxes are a 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 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 statement. <br />Nebraska ID Number <br />10253165 <br />Lien Serial Number <br />11593497 <br />Dale of Lien <br />July 16, 2015 <br />sign <br />here <br />Business Name and Location Address <br />'s Signal re <br />�!!�1 /L 1 71 <br />Lien Filed Wilh; <br />® Register of Deeds 0 County Clerk <br />Authorized Signature Title <br />201505031. <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Federal IO Number <br />262511976 <br />Social Security Number <br />Lien Type: <br />© original 0 Continuation ci Corrected <br />Revenue Agent <br />Title <br />Revenue Senior Agent <br />NE 5Ao of 5 •t• Jcnn A Oa re - UCG =TL <br />9915758388 -3 Age: 1 <br />STEEL WRTER BUILOERS LLC <br />Filed: 07/24/2015 11:56 Am <br />County <br />HALL <br />.194f F. <br />spouse's social Security Number <br />Taxpayer Name and Mailing Address <br />STEELWATER BUILDERS LLC <br />PO BOX 374 <br />DONIPHAN NE 63832 <br />I certify Mal the Nebraska Department of Revenue has complied with the laws of rite Stale of Nebraska In determining the amount shown to be due, <br />and that the I xpayer has failed to pay the amount due after demand. This Notice of Slate Tax Lien is an effective lien and serves to continue the priority of <br />the Sla ;'* =rest in the affected pr 09drfy�i� the taxpayer. <br />07/20/2015 402 - 471 -6067 <br />()ale Phone Number <br />Date <br />44184-1974 flev. 6-2043 Supersedes 4- 949 -1971 Rev.2 -2002 <br />