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Jan. 25. 2019 11:03AM NE Secretary c.f State <br />Good Uhl. Croat SaWCD. <br />imrs*Ity, MON. <br />2 1Q)45 172 <br />NB Sec of Slate - Ackert B. Bonen <br />Filing Document #; 1901001E179-6 Pages: 1 <br />Debtor Maroc P1t1C N MCCOOL <br />riling Dare and Time: 0125/301910:76 AM <br />Notice of State Tax Lien <br />This Nodes of elate Tex Lien Is issued by the Nebraska <br />Depertrnenl of Revenue for unpaid lanes administered by the Tax <br />Commissioner, Teres, including pensItIee, interest, and costa, <br />whloh are shown below, ere due 1rorn the taxpayer and remain <br />unpaid after demand.These tarsi are a lien for all property located <br />in the county end rights to properly owned by the taxpayer or <br />acquired before the expiration of this lien.This Tian will expire and <br />become unenforceable 10 years after the date of recording If no <br />continuation abatement ie recorded on or prior to the expiration of <br />the previous lien or continuation elaten'enl, <br />PLEASE 00 ear WRITE IN THIS SPACE <br />Nebraska ID Number <br />9282181 <br />Federal ID Number <br />203400553 <br />Penalty <br />Ian Serial Number <br />11921767 <br />lien filed WU <br />NJ Repner 01 peon El COWS' Clerk <br />Social Security Number <br />XXX -XX -4347 <br />SPeuees 6S <br />til Secuelly Nw$Oer <br />Data d Llan <br />Jan nary 17, 2019 <br />Llan Wr <br />® original Q ce *...Marl <br />1,063.67 <br />county <br />HALL <br />.00 <br />i e>ornaeo <br />Business Name and Location Addraee <br />Taxpayer Name and MailingAddreee <br />ERIC N MCCOOL <br />1104 W 12TH ST <br />GRAND ISLAND NE 68801 <br />Tex Program <br />Tex Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />)nterest <br />Costs <br />Total Due <br />Sales <br />05/01/2015 - 12/31/201.5 <br />04/03/2016 <br />.00 <br />1,063.67 <br />_ 141.60 <br />.00 <br />1,205.27 <br />Salts <br />01/01/2016 - 09/30/2016 <br />12/24/2016 -- <br />1,114,09 <br />1,359.00 <br />258.01 <br />.00 <br />2,731.10 <br />Sales <br />10/30/2016 - 09/30/2018 <br />12/31/2018 <br />22,680.00 <br />4,536.00 <br />839.16 <br />.00 <br />28,055.16 <br />Total <br />31,991.53 <br />sign <br />here <br />I caddy that aha Nebraska Deparenanl al Fiaapnya has onmpllad with Ihp laws 01 btu Slabs 01 Nobresle in drtramilnisg the anwtl shown b bo due. <br />WV Mal Ina laepaya hes POW to pay Ore amount cop after demen0.Tnlo Noloa of Mato lex Lien is an a Iee*ve Non OW serves to continua Ina priority of <br />Ms Atwell Karam! W the Wanted properly 01 pa mrpalm . <br />Rover= Senior Aunt <br />01/101209 402-471-5709 <br />lab Dalo Stone mbar <br />Revenue Senior Agent i 141! <br />TAW <br />Daae <br />4-404-1894 nae 0.2019 9vse40ee9 4109-1974 Asa e.20l1 <br />