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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 />Saks <br />09/01/2012 - 12/31/2013 <br />07/01/2014 <br />_00 <br />.00 <br />36.52 <br />,00 <br />36.52 <br />Sales • <br />01/01/2014 - 02/28/2014 <br />09/02/2014 <br />.00 <br />.00 <br />5.06 <br />.00 <br />5.06 <br />Sales <br />05/01/2014 - 05/31/2014 <br />09/02/2014 <br />.00 <br />.00 <br />.52 <br />.00 <br />.52 <br />Sales <br />03/01/2014 - 03/31/2014 <br />10/01/2014 <br />.00 <br />.00 <br />1.43 <br />.00 <br />1.43 <br />Sales <br />07/01/2014 - 07/31/2014 <br />10/01/2014 <br />.00 <br />.00 <br />.34 <br />.00 <br />_34 <br />Sales <br />06/01/2014 - 06/30/2014 <br />12/01/2014 <br />.00 <br />.00 <br />3.07 <br />.00 <br />3.07 <br />Sales <br />09/01/2014 - 09/30/2014 <br />12/01/2014 <br />.00 <br />.00 <br />1.76 <br />.00 <br />1.76 <br />Sales <br />04/01/2014 - 04/30/2014 <br />01/02/2015 <br />.00 <br />.00 <br />3.13 <br />• .00 <br />3.13 <br />Sales <br />10/01/2014 - 10/31/2014 <br />02/02/2015 <br />.00 <br />.00 <br />1.15 <br />.00 <br />1.15 <br />Sales <br />11/01/2014 - 12/31/2014 <br />04/01/2015 <br />.00 <br />.00 <br />2.72 <br />.00 <br />2.72 <br />Sales <br />01/01/2015 - 04/30/2015 <br />06/01/2015 <br />.00 <br />18.91 <br />2.40 <br />.00 <br />21.31 <br />Total <br />77.01 <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 Ilen or continuation statement. <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />11801654 <br />Federal 0 Number <br />464209680 <br />Ilan Serial Number <br />11600025 <br />Llen Filed With: <br />Social Security Number <br />X -) -3837 <br />Spouse's Social Security Number <br />Ki Register of Deeds • county Clerk <br />Dale of Lien • <br />October 7, 2016 <br />Lien Type: <br />County <br />HALL <br />1 original • continuation <br />■ Corrected <br />Oct. 20. 2016 3:46F'M' NE Secretary of State - UCC <br />Nebraska Department of <br />REVENUE <br />Business Name and Location Address <br />toe Merest in the affected prop e taxpayer. <br />h ere Preparer'e$i <br />/ / I1 /1 <br />sign <br />•polnori '' 1SlgnalLre <br />Notice of State Tax Lien <br />Revenue Agent <br />. Title <br />Revenue Senior. A <br />Title <br />NE Sac cr 5iale John R Gala - IJCC STL <br />9916781471-1 Pas: 1 <br />.. <br />HARDY APRIL <br />Filed: 10/20/2016 10:29 I1M <br />Taxpayer Name and Mailing Address <br />APRIL HARDY <br />380 N BROADWELL AVE <br />GRAND ISLAND NE 68803 <br />2P 45 8 <br />1 certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska In determining the amount shown.to 0e due, • <br />and that I = taxpayer has felled to pay th nt doe after demand. Tills Notice of Stale Tax Lien le an affective pen and serves to continue the priority of <br />ja/ /174 402- 471 -6067 <br />Date Phone Number <br />Dale <br />4- 494-1974 Rev. 8-2013 Suoeresdee 4- 949 -1974 Rev.2 -2002 <br />A <br />