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09/27/2001 16:55 FAX 14024714429 <br />Ir <br />department <br />Of revenue <br />NEBRASKA UCC <br />200109840 <br />0002 <br />Ne iee of L4•4. UCC STL <br />f � , <br />99b11891I028 -5 8 Pus t <br />FEledN09 /2712bel 03:f59 PM <br />Notice of State Tax Lien <br />PLEASE DO NOT wRRE IN THIS SPACE <br />This Notice of State Tax Lien is issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice Is hereby gives that taxes including penalties and <br />interest, which are shown below, are due from the taxpayer specified <br />Wow and remain unpaid after demand. These taxes constitute a lien in <br />the county for real and personal property belonging to the taxpayer or <br />hereafter acaulred. <br />aoc+ai security or Federal LD. Number spouse's S <br />7 2 0 5 5 4 6 12 Register of Deeds [] Caunry Clerk S 0 6— 6 4 — 3 7 3 2 <br />Lien Serial N umber Lien Type <br />01/09/391 Original Date of Ln county <br />�` ❑Continuation ❑Corrected 9 ;1910, HALL <br />BUSINESS NAME AND LOCATION ADDRESS <br />Business Name TAXPAYER NAME AND MAILING <br />Nanw <br />ELITE :BUSINESS CONCEPTS THOMAS P METTENBRINK <br />Street Address <br />710 W 4TH ST Street or Other Mailing Addms <br />C 1324 W NORTH FRONT ST <br />State Zip Coda city State <br />GRAND ISLAND NE 68801 GRAND ISLAND NE <br />Tam <br />Tax Period <br />+ r + / VV — <br />01 12/31/00 <br />Dater { Amount of Tax <br />Aaaoserrtere I Penalty Infersst Additions <br />9/7/01 835.30 83.53+ 48.81 <br />Please return to: <br />STATE OF NEBRASKA <br />DEPART MNT OF REVENUE <br />1811 WEST 2ND ST STE 460 <br />GRAND ISLAND NE 68803 <br />ZIP Code <br />668801 <br />Balance of <br />Aaeenment Due <br />I TOTAL $ <br />I her certify that the Nebraska Department of Revenue has compsed with the revenue laws of the State of Nebraska in the determination <br />of the amount n, it snly s due• antl ttte taxpayer has felled to pay the amolyd due after demand. It this Notice of State Tax Lien is an exterslon of <br />an effective llien,�k �e�rves to mrrtlnue the priority of the stave's int in the effected pro e pre t9xpayer <br />967.64 <br />967.64 <br />NEBRASKA DEI <br />Prow an iwcw peer <br />r+rlR Vupy t.'OUNTY OFFICE - Canary Copy <br />4-4"74 Rev. 10-95 Supersedes 4-494 -74 Rev, $.95 <br />