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Prop Hm <br />Tax Period <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2015 <br />05/11/2016 <br />2,614.00 <br />143.68 <br />73 -05 <br />2,830.73 <br />Total <br />$2,830.73 <br />og <br />Mar.24. 2017 2:10PM NE Secretary of State — UCC No. 0158 F. 2 <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 explration of this llen.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 lien or continuation statement. <br />Nebraska ID Number <br />28754808 <br />Lien Serial Number <br />11185710 <br />Dale of Lien <br />03/21/2017 <br />here <br />Lien Filed With: <br />® Register of Deeds ❑ County Clerk <br />Lien Type; <br />® Original [JContinuation El Corrected <br />Business Name and Location Address <br />sign Oltistiw, i) LhnosA <br />Pm rs signature <br />thorized Signalure <br />Notice of State Tax Lien <br />Revenue Agent <br />Title <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Federal ID Number <br />t 5a...£ 51. ¢ John A Gale - UCC STl <br />111 hill <br />Social Security Number <br />XXX -XX -8477 <br />9917789206 -0 Pus: 1 <br />: VANMARK LARRY J <br />riled; 03/24/2017 05:50 AM <br />LARRY J VANMARK <br />LAURIE A VANMARK <br />423 N CHEROKEE <br />GRAND ISLAND NE 68803 <br />Title <br />Revenue Supervisor <br />201701813 <br />Spouse's Social Security Number <br />XXX- XX4800 <br />County <br />HALL <br />Taxpayer Name and Mailing Address <br />I certify that the Nebraska Department of Revenue has compiled with the laws of the Slate ol Nebraska in determining the amount shown to be due, <br />and that the taxpayer has fatted to pay the amount due after demand. This Note of State Tax Lien is an effective ten and serves to continue the priority of <br />me State's interest in the affected property ol the taxpayer. <br />03/21/2017 (402)471 -5712 <br />Date Phone Number <br />03/21/2017 <br />Dale <br />4.494 -la74 Rev. earns Supersedes 4- 949.1974 Rat 2- <br />