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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 />04/01/2017 - 07/31/2018. <br />09/04/2018 <br />38,790.48 <br />3,663.35 <br />806.23 <br />.00 <br />43,260.06 <br />Tire Fee <br />01/01/2016 - 12/31/2017 <br />09/05/2018 <br />.00 <br />84.80 <br />29.22 <br />.00 <br />114.02 <br />Withholding <br />01/01/2018 - 06/30/2018 <br />08/10/2018 <br />8,411.67 <br />1,057.13 <br />62.51 <br />.00 <br />9,531.31 <br />Total <br />52,905.39 <br />Good Life. Great Service. <br />13. 2013 3:1t PM NE Secre.tary St N..0966 F. 5./8 <br />G CpAYTMQNr OP' N[VCNV! <br />Notice of State Tax Lien <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 Iien.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 />9221042 <br />Lien Serial Number <br />11813619 <br />Date of Lien <br />September 13, 2018 <br />sign <br />here <br />Lien Filed With: <br />NI Register of Deeds J County Clerk <br />Llen Type: <br />Original <br />Business Name and Location Address <br />Continuation <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Federal ID Number <br />900068518 <br />Social Security Number <br />co <br />2 01806132 , <br />NE sac of 54ale <br />IN 111111111 <br />-John A 6 •I41 - LICE STL <br />PE A TOMOTIVE SERVICES I <br />P9s. 1 <br />Fllod, 09/18/2018 11;09 RN <br />Spouses Social Security Number <br />County <br />HALL <br />Taxpayer Nance and Mailing Address <br />PERSONAL AUTOMOTIVE SERVICES INC <br />2404 W LINCOLN HIGHWAY <br />GRAND ISLAND NE 68803 <br />I certlty teal the Nebraska Department of Revenue has complied with the Taws of the Slate of Nebraska in determining the amount shown to be due, <br />and that the taxpayer has failed 10 pay the = ount due after demand. This Notice of Stare Tax Lien is an effective lien and serves b continue the priority of <br />the Ste Merest In the affected p . erl „ r f lne axp . - <br />• —_,-411L__ <br />Il' <br />fi r' - .Ignature <br />J1 al( <br />horiz <br />gnature <br />Revenue Agent 09/06/2018 <br />Title Dale <br />Revenue Senior Agent <br />402 -471 -5711 <br />pii07 Number <br />Title Date t \ � <br />4- 494 -1974 Rev. B-201a Sueereedee 4 -949 -1974 Rfli \ 9 <br />