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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 />Sales <br />10 /01 /2016 - 10/31/2016 <br />12/01/2016 <br />:00 <br />233.00 <br />.57 <br />.00 <br />23157 <br />Sales <br />11/01/2016 - 11/30/2016 <br />01/06/2017 <br />2,689.53 <br />268.93 <br />26.53 <br />20.00 <br />3,004.99 <br />Sales <br />02/01/2017 - 02/28/2017 <br />04/03/2017 <br />.00 <br />89.70 <br />.15 <br />.00 <br />89.85 <br />Total <br />3,328.41 <br />06 <br />Apr. 24. 2017 2:39FM NE Secretary of ':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 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 lien or continuation statement. <br />Nebraska ID Number <br />8923736 <br />Lien Serial Number <br />11786943 <br />Dale o1 Lien <br />April 19, 2017 <br />sign <br />here <br />Business Name and Location Address <br />4tk <br />Proper ai nature <br />Authorized Signature <br />Notice of State Tax Lien <br />Lien Filed With: <br />® Reglaler or Deeds ❑ County Clerk <br />Lien Type: <br />Original ❑ Continuation Q Corrected <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Federal ID Number <br />470881364 <br />Social Security Number <br />Revenue Senior Agent <br />Title <br />Revenue Senior Agent <br />Title <br />N4 see of Ste*. John Gole - SrL <br />9917790954—El Pus : 1 <br />TOOL BARN RENTALS INC <br />Filed: 04/24,21117 1 0_24 AM <br />Spouse's Social Semidry Number <br />County <br />IIALL <br />2p1'7 <br />Taxpayer Name and Mailing Address <br />TOOL BARN RENTALS INC <br />624 S WEBB ROAD <br />GRAND ISLAND NE 68803 <br />I certify that the Nebraska Department of Revenue has complied with the laws at the Stale or Nebraska In determining the amount shown to be due. <br />and that the taxpayer has tailed to pay the amount due after demand, This Notice of State Tax Lien is an effective lien and serves to continue the priority al <br />the State's interest in the affected property of the taxpayer. <br />04/19/2017 402- 471 -5727 <br />Pale Phon Number <br />Date <br />-49.1-1974 Rev, a-201 3 Buparw4ec 4949 -1044 Rev. 2 -2002 <br />