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N_EBR r& 4A <br />cxX1 I to. Great Servic@. <br />111114.1114111•11. 01.1.1.[AMIS <br />202005609 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2008000021-9 <br />Debtor Name: GAS ISLAND II LLC <br />Filing Date and Time: 08/03/2020 11:21 AM <br />Pages: 1 <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 Ilen.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 DO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />11693649 <br />Federal ID Number <br />464353089 <br />Lien Serial Number <br />12058109 <br />Lien tied With. <br />Social Secunty Number <br />Spouse's Social Security Number <br />it Register of Deeds ❑ county Clerk <br />Date 01 Lien <br />July 22, 2020 <br />lien Type: <br />® original 0Continuation 0Corrected <br />County <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />GAS ISLAND II LLC <br />2012 N WEBB ROAD <br />GRAND ISLAND NE 68803 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Sales <br />12/01/2019- 12/31/2019 <br />01/29/2020 <br />150.56 <br />241.17 <br />43.11 <br />120.00 <br />554.84 <br />Sales <br />01/01/2020 - 02129/2020 <br />07/07/2020 <br />9,070.00 <br />1,814.00 <br />172.08 <br />.00 <br />11,056.08 <br />Total <br />11,610.92 <br />sign <br />here <br />I certify that the Nebraska Department 04 Revenue has complied with the laws of the Stale of Nebraska in deterrmrng the amount shown to be due. <br />and that the taxpayer has fatted to pay the amount due after demand. This Notice of Slate Tax Lien is an elective lien and serves to continue the priority of <br />th/1�tales interest t allecled property Of the taxpayer. <br />�r.• l,[ <br />Authorized :. r41 r. <br />Lure <br />'2LylK/ti1r�„� <br />Revenue Senior Agent <br />07/15/2020 402-471-5709 <br />Title Date Phone meet <br />Revenue Senior Agent 7/� ZD11� <br />Tale Date <br />4.484.1914 Re, 8.2018 Supersedes 4.949.1914 Rev. 8.2013 <br />