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Tax Category Tax Period Data of Amount of Tax Penalty Interest Additions Balance of Number Assessment Assessment Due City Feb. 24. 2017 2:34FM Lien Serial Number 163650027 Date of Lien Business Name Street Address 22 02/22/2017 BUSINESS NAME AND LOCATION ADDRESS 2009 Aut •rized Signature Lien Filed With Register of Deeds LJCounty Clerk Lien Type a e Zip o. e 351.00 Title 201701208 This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are shown below, are due from the taxpayer specified below and remain unpaid after demand. These taxes constitute a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. Nebraska Identification Number 44569262 Federal Identification Number Original fContlnuation Eicorrectw Name BEVERLY A REDWINE Street or Other Mailing Address 2216 GATEWAY itr 87.75 enue Senior A•ent Social Security Number XXX -XX -2715 GRAND ISLAND County HALL 91.33 Date NE Lec ei Skake John A A.]e - N STL l 9917737871 - 3 PBS 1 REDWINE BEVERLY A Filed; 02/Z4f2B 12.27 PM Vi NUE NOTICE OF STATE TAX LIEN base WW 1' lYwr..+bm'_ftd.Q410. PLEASE DO NOT WRITE IN THIS SPACE Spouse's Social Severity Number TAXPAYER NAME AND MAILING ADDRESS Late NE 3611) F. 3 TOTAL $ 530.08 ere 'y net that the Nebraska Department o Revenue as compl ed with the revenue laws of the State of Nebraska In the determination of the amount shown to be due, and he taxpayer has failed to pay the amount due after demand. If his Notice of State Tax Lien Is an extension of an effective lien, It serves to continue the lority of the state's interest in the affected property of he taxpayer. O/ .A Re enue A ent sign Prepare!' Signature I/ here Telephone Number Date 4 - 494 - 1974 Rev. 24002 Supersedes 4.494 Rev, 10 Zip Co. e 68803 530.08 402 471 -5789