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Tax <br />Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2009 <br />12/29/2015 <br />4,319.03 <br />1,138.75 <br />1,095.30 <br />6.553.08 <br />Individual <br />2010 <br />12/29/2015 <br />3,922.00 <br />1,096.00 <br />747.65 <br />5,765.65 <br />Individual <br />2011 <br />12/29/2015 <br />4,040,00 <br />1,129.42 <br />567.59 <br />5,737.01 <br />Individual <br />2012 <br />05/08/2016 <br />3,324.00 <br />912,16 <br />375.30 <br />4,611.46 <br />Total <br />$22,667.20 <br />Jul. 6. 2516 4:05FM NE Secretary of State — UCC <br />rtiri/ls -z` <br />N ebraska Department of <br />REVENUE <br />This Notice of State Tax Llen 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 llen.Thls lien will expire and <br />become unenforceable 10 years after the data 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 />44096453 <br />Lien Serial Number <br />11673784 <br />Date o1 Lien <br />06/29/2016 <br />Sign <br />here <br />Lien Filed With: <br />® Re of Deeds ❑ County Clerk <br />Lien Type: <br />ononai <br />Business Name and Location Address <br />Notice of State Tax Lien <br />Continuation <br />201604228 <br />Title <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Federal ID Number <br />Social Security Number <br />XXX -XX -2715 <br />Revenue Agent <br />Title <br />Revenue Supervisor <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509 -4609 <br />El Corrected <br />Taxpayer Name and Marling Address <br />BEVERLY A REDWINE <br />2216 GATEWAY AVE <br />GRAND ISLAND NE 68803 <br />Vo 7263 P. 4'4 <br />I E f.c 01 11itte Bann n 6.11 - -- <br />9916776494-2 Pgs' <br />REDWINE BEVERLY R <br />Filed: t713612318 12:22 P11 <br />Spouses Social Security Number <br />county <br />HALL <br />I certify that the Nebraska Department of Revenue has complied with the taws of the Stale of Nebraska In determining the amount shown to be due, <br />and trial the taxpayer has failed to pay the amount due atter demand. This Notice ai State Tax Lien is an etiectNe lien and serves to continue the priority of <br />the Slates Interest to the el the taxpayer, <br />06/29/2016 <br />Date <br />(308)632.1206 <br />Phone Number <br />06/29/2016 <br />Date <br />4-494-1874 Be 8-2013 Supersedes 4- 9494974 Rev. 24002 <br />1 t <br />