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Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />03/01/2016 - 04/30/2016 <br />07/01/2016 <br />.00 <br />144.59 <br />5 -27 <br />.00 <br />149.86 <br />01/01/2016 - 03/31/2016 <br />05/10/2016 <br />.00 <br />11.37 <br />.11 <br />.00 <br />11.48 <br />Total <br />161.34 <br />Jul. 19. 2016 3:29PM NE Secretary .t State — UCC <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 Ilen.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 />th previous {ion OI' ContinilatibilIt13te1neTit. • <br />reties tkrrErNur e1 .. ... - - <br />. 11841931 <br />Lien Serial Number Llen Flied With: <br />11698622 ® Register of Deeds ❑ County Clerk <br />Date of Lien Lien Type: <br />July 4, 2016 ® Original ❑ Continuation <br />Business Name and Location Address <br />Sales <br />Tax Program <br />Withholding <br />sign <br />here <br />l comity that the Nebraska Department <br />and that the taxpayer has tailed to pay <br />the Sla ems! in the affected pro <br />Notice of State Tax Lien <br />HE Sac of Si.ie John 0 Oale - UGC STL <br />20 <br />9916777096 -9 P98: i <br />MOTHER MAID GLEANING LLC <br />Filed; 0711e/201b 11 HM <br />PLEASE DO NOT WRITE IN THIS SPACE <br />FedaraTtOrNomber <br />465568737 <br />Social Security Number <br />❑ Corrected <br />county <br />HALL <br />�n <br />No. 7381 <br />Spouses Social Security Number <br />Taxpayer Name and Mailing Address <br />MOTHER MAID CLEANING LLC <br />PO BOX 5766 <br />GRAND ISLAND NE 68802 <br />of Revenue has complied with the laws or the State of Nebraska in determining the amount shown to be due, <br />nt due atter demand. This Notice of Slate Tax Lien is an effective lien and serves to continue the priority of <br />taxpayer. <br />Revenue Agent 43/2a/4' 402- 471 -6067 <br />Title Date Phone Number / <br />Revenue Senior Agent 7' /V <br />Title Date <br />d -494 -1970 Hey. 8-2013 Supersedes 4-949 -1974 Rev. 2-2002 <br />