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Apr. 23. 2013 3:25PM NE Secretary a t State — UCC <br />Nebraska oepertment 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 all property located <br />In the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this Tien, This Ilen 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 />47591749 <br />Lien Serial Number <br />11804969 <br />Date of lien <br />April 10, 2018 <br />Notice of State Tax Lien <br />Lien Filed With: <br />Register of Daeda a County Clerk <br />Lien Type: <br />IN Original ❑ Continuation <br />Federal ID Number <br />Social Security Number <br />XXX -XX -7376 <br />Business Name and Location Address <br />Tax • a er Name and Mailin • Address <br />Tax Program <br />Individual <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 be due. <br />and that the taxpayer has failed to p emou. - atter demand This Notice of State Tax Lien Is an effective lien and serves to continue the priority of <br />the State's Interest in the -u tar =•._, t + + et. <br />Authorized Signature <br />Tax Period <br />2016 <br />Date of <br />Assessment <br />05/12/2017 <br />Tax <br />$254.00 <br />0 Corrected <br />Penalty <br />$12.70 <br />2�QO 2 <br />NE Sec of Ste /e Jehn A Gala - UCC STL <br />111 11 <br />9915810134 -7 Ass: 1 <br />REIMERS LANCE M <br />Filed: 04/23/2016 12;52 PM <br />PLEASE DO NOT WRITE INTHIS SPACE <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 6S509 -4609 <br />LANCE M REIMERS <br />521 SHERMAN AVE <br />GRAND ISLAND NE 68803 <br />Spouae'a Social Security Number <br />County <br />HALL <br />Interest <br />$7,52 <br />Costs <br />Total <br />Total Due <br />274.22 <br />$27422 <br />(308)632 -1206 <br />Phone Number <br />04/10/2018 <br />Dale <br />4- 4e4.1974 Rev. 8 Supereedes 4.949 -1974 Rex. 2 -2002 <br />