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NE:BRAS34A-, <br />Goon, Ldp. Grpa: S.vv¢p <br />2.0210168 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2103000002-8 Pages: 1 <br />Debtor Name: SPORTSMANS BAR <br />Filing Date and Time: 03/01/2021 09:14 AM <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 />PLEASE DO NOT WRITE kit THIS SPICE <br />Nebraska ID Number <br />13292005 <br />Federal ID Number <br />830957857 <br />Lien Serial Number <br />12168784 <br />Lien Filed With: <br />® Register of Deeds O County Clerk <br />Soc1N Security Number <br />Spaces Social Security Number <br />Date of Lien <br />February 16, 2021 <br />Lien Type: <br />0Corrected <br />Cantly <br />HALL <br />►:f Orginai ❑Comirtuatian <br />Business Name and Location Address <br />Taxpayer Nene 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 Due <br />Sales <br />01 /012020 - 01/31/2020 <br />05/01/2020 <br />1,864.83 <br />186.48 <br />87.67 <br />.00 <br />2,138.98 <br />Sales <br />02/01/2020 - 02/29/2020 <br />04.101/2020 <br />1,813.14 <br />181.31 <br />78.03 <br />.00 <br />2,072.48 <br />Sales <br />03/01/2020-03/31/2020 <br />05/01/2020 <br />475.95 <br />73.86 <br />18.48 <br />.00 <br />568.29 <br />Sales <br />06/01/2020 - 06/30/2020 <br />08/03/2020 <br />303.46 <br />30.35 <br />8.00 <br />.00 <br />341.81 <br />Sales <br />07/01/2020 - 07/31/2020 <br />09/01/2020 <br />1,694.61 <br />169.46 <br />37.42 <br />.00 <br />1,901.49 <br />Sales <br />09/01/2020 - 09/30/2020 <br />11/02/2020 <br />.00 <br />155.75 <br />.64 <br />.00 <br />156.39 <br />Sales <br />10/012020 - 10/31/2020 <br />12/01/2020 <br />1,167.88 <br />116.79 <br />11.07 <br />.00 <br />1,295.74 <br />Sales <br />11/01;2020- 11/30/2020 <br />01/04/2021 <br />1,016.03 <br />101.60 <br />5.45 <br />.00 <br />1,123.08 <br />Saks <br />12/01/2020- 12/31/2020 <br />02/01/2021 <br />1,204.74 <br />149.37 <br />2.72 <br />.00 <br />1,356.83 <br />Total <br />10,955.09 <br />sign <br />here <br />I certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska in determining the armed shown to be clue. <br />and that the taxpayer has failed to pay the amount due after demand. This Notice of State Tax Lien ban affective hen and serves to continue the priority OI <br />the - - s Interest in - .acted property of the taxpayer. <br />4.a01114/0241," Revenue Senior Agent 02/08/2021 402-471-5709 <br />Tide Date Phone N <br />Revenue Senior Agent 2/2J/ Z02/ <br />Authai <br />re <br />Title <br />Date <br />ewes.1974 Per. 41.2019 Supersedes 4.149.1974 nee. 64013 <br />