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NEER -A <br />DruuTrkn, Os' 111.1.Ve <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2004000425-5 Pages: 1 <br />Debtor Name: SPORTSMANS BAR <br />Filing Date and Time: 04/08/2020 10:03 AM <br />Notice of State Tax Lien <br />20 2002155 <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 />PLEASE 00 NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />13292(105 <br />Federal ID Nemec:, <br />830957857 <br />Lien Serial Number <br />12051124 <br />hien Filed With. <br />® Register of Doects © County Clerk <br />Social Security Number <br />Stones Social Security Narrlbar <br />Date of :.ren <br />March 25, 2020 <br />Lien Type <br />U odginai f Cominuataxa (-i Corrected <br />Cc <br />HALT.. <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />SPORTSMANS BAR <br />501 N PINE STREET <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Duc <br />Sales <br />10:01/2018-0131/2019 <br />05/032019 <br />5,538.87 <br />1,108.00 <br />332.05 <br />.00 <br />6,978.92 <br />Saks <br />02/0112019 - 12131/2019 <br />02/2712020 <br />16.493.89 <br />1,518.32 <br />477.43 <br />.00 <br />18.489.64 <br />Total <br />25,468.561 <br />I certify that the Nebraska Department of Revenue has compbed <br />and that the taxpayer has failed to pay the amount due atter demand, <br />tno State's in rest in the affected property of the taxpayer. <br />sign <br />here ' Prepares <br />Authorized S,gna r/ <br />the laws of the State of Nebraska or t1eternuning the amount strewn to be due, <br />Vase of State Tax Oen Lc an effective Nen and serves to cont,rrue the priority of <br />Revenue Senior Agent <br />Tale <br />Revenue Senior Agent <br />03/1812020 402-471-5709 <br />Date Phone Number <br />Toe Date <br />a -4o4 -107a %iev. x-2010 5o crscees ...Ora 2c`3 <br />