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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 />. . <br />Sales <br />04/01/2015 - 06/30/2015 <br />07/25/2016 <br />_ <br />100.00 <br />.35.00 <br />3.76 <br />.00 <br />. 138.76 <br />Sales . <br />01/01/2016 03/31/2016 <br />07/25/2016 <br />100.00 <br />35.00 <br />1.50 <br />.00 <br />136.50 <br />Sales <br />10/01/2015 - 12/31/2015 <br />07/25/2016 <br />100,00 <br />35.00 <br />2.25 <br />.00 <br />' . 137.25 <br />Saks <br />07/01 /2015 - 09/30/2015 <br />07/25/2016 <br />100,00 <br />: 35.00 <br />. 3.01 <br />.00 <br />. 138.01 <br />Total <br />550.52 <br />Dec. 1. 2016 3:00PM ,NE Secretary of State — UCC <br />Neh raak3 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 lights 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'lion or continuation statement . <br />• Nebraska 10 Number <br />11918500 <br />Lie Sesialdk+mhe( <br />1160016.7 <br />Oate of lien . <br />October 20, 2016 <br />sign <br />here <br />Adiherixed Signature • <br />I iOn gilOd With: <br />] Register of Deeds <br />Lien Type' <br />© 0rlglnal <br />Notice of State Tax Lien <br />County Clerk <br />Continuation <br />201608057 <br />Title <br />PLEASE DO NOT WRITE IN THIS SPACE <br />federal ID Number <br />Sncial Security Number <br />XXx -XX-7410 <br />L Co <br />Tate <br />Revenue Senior Agent <br />N! S.c of Si.4. John A <br />i <br />• County <br />HAIL <br />ROBERTO S MONTETO <br />236 W ROBERTS ST • <br />GRAND ISLAND NE 68803 <br />• .■o. 8934 <br />P. 2 <br />a.1. uce SIL <br />9916783344-4 Pox 1' <br />riONTEJV RobE1tTO J <br />Filed: 12/01/2016 08:21 API <br />Spouse's Social Security Number <br />Business Name and Location Address <br />Tax • a er Name and Mailing Address <br />I certify that the Nebraska Department of Revenue has Compiled with the laws of the State of Nebraska In determining the amount shown to tie due, <br />and that the taxpayer has tailed to pay the amount due alter demand. This Notice of State Tax Lien is an effective lien and serves to continue the priority of <br />Irte Staff merest in Inc atfeeted pro• f the taxpayer. <br />Revenue Agent <br />402 -471 -6067 <br />Plume Number . <br />• <br />4. 4441974 Rev. 5-2019 Superieties 4449.1074 -2002: ' <br />