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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 />01/01/2014 - 12/31/2014 <br />08/11/2015 <br />2,510.84 <br />502.17 <br />31.16 <br />.00 <br />3,044.17 <br />Total <br />3,044.17 <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 lien.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 />PLEASE DO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />11425601 <br />Federal ID Number <br />454014985 <br />Lien Serial Number <br />11696310 <br />Llen Fled With: <br />Social Security Number <br />Spouse's Social Security Number <br />pi Register of Deeds ■ County clerk <br />Data of Lien <br />January 18, 2016 <br />Lien Type: <br />County <br />HALL <br />fa Original Q Continuatkm <br />U Corrected <br />Mar. 1. 2016 3:14PM VE Secretary of State — UCC <br />Nebraska Department or <br />REVENUE <br />sign <br />here <br />Business Name and Location Address <br />0 N O 1..A <br />Notice of State Tax Lien <br />7 ELLIZABETH LLC <br />1705 GRETCHEN AVE <br />GRAND ISLAND NE 68803 <br />No. 5313 P. 3 <br />NI Sec of %4m5* John A 6A1 <br />9916765406 -6 <br />J ELLIZRBETH LLC <br />Filed: 03/01/2018 12:10 PM <br />Taxpayer Name and Mailing Address <br />SEC STL <br />Pas- 1 <br />I certly that the Nebraska Department al Revenue has complied with the laws of the Stale of Nebraska in determining the amount shown to be due. <br />and that the taxpayer has failed to pay �� • of due attar demand. This Mottos of Stale Tax Lien Is an effective lien and serves to continue the priority of <br />lbs Sl . - . terest In the affected pay taxpayer. <br />Revenue Agent P � 402- 471 -6067 <br />Tile • ate Numb <br />Revenue Senior Agent ��v- /A, <br />Title Dale <br />4-4041974 Rev. 62019 Supersedes 4144 -1974 Rev. 2 -2002 <br />