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Tex Program <br />Tax Period <br />Assessment <br />Tex <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2006 <br />10/1612015 <br />1,883.00 <br />470.75 <br />832.39 <br />3,186.14 <br />Individual <br />2007 <br />10116/2015 <br />799.00 <br />237.75 <br />289.11 <br />1.325.86 <br />Individual <br />2008 <br />10/16/2015 <br />846.00 <br />245.50 <br />245,73 <br />1,337.23 <br />Individual <br />2009 <br />10/16/2015 <br />1,366.00 <br />365.50 <br />328.48 <br />2,059.98 <br />Individual <br />2010 <br />10/16/2015 <br />862.00 <br />241.29 <br />164.18 <br />1,267.47 <br />Individual <br />2011 <br />10116/2015 <br />794.00 <br />222.36 <br />111.42 <br />1,127,78 <br />Total <br />$10,304.46 <br />Jun. 29. 2016 3:32FM NE Secretary of State — UCC <br />201604032 <br />Nebraska 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 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 />Nebraska ID Number <br />19337051 <br />Lien Serial Number <br />11673553 <br />Dale of Lien <br />06127/2016 <br />sign <br />here <br />A coked Signature <br />Notice of State Tax Lien <br />lJen Filed With <br />IN Register of Deeds Q County Clerk <br />Lien Type: <br />® Original <br />Continuation <br />s <br />vApplir <br />Signature <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Federal ID Number <br />Social Security Number <br />XXX- XX-4678 <br />❑ Corrected <br />ELWYNE L MYERS <br />3024 GOLDENROD DR <br />GRAND ISLAND NE 68801 <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />Title <br />Cattily <br />HALL <br />No. 7191 P. <br />E Sae of S • a Jahn P este . UCC STL <br />Spouaex Social Security Number <br />I certify that the Nebraska Depetlmerd of Revenue has complied with the law of the State of Nebraska in determining the amount shown to be due, <br />and that the taxpayer has Wad to pay the amount due after demand. This Notice of Slate Tarr Lien is an effective pen and serves to continue the priority of <br />the Slate's Interest in the affected property of the taxpayer. <br />06/27/2016 <br />Dale <br />8018775039 -8 <br />MYERS ELWYNE L <br />Filed: 0812912018 01:30 PA <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />(402)471 -6712 <br />Phone Number <br />06127/2016 <br />Dale <br />4-4941571 Res. 8-2019 Supersedes 4-049 -1974 Rev. 2 - 2002 <br />Pas: <br />i <br />