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04/20/2004 15:05 FAX 14024714429 NEBRASKA UCC <br />200403886 <br />U003/003 <br />12012004 12A2 PM <br />NOTICE OF STATE TAX LIEN <br />PLEASE DO NOTtTE IN THIS SPACE <br />This Notice of State Tax Lien is issued by the Nebraska Depart ment of -- <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice is hereby given that taxes including penalties and <br />Interest, which are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These taxes constitute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter acquired. <br />Nebraska Identification Number Lien Filed With Social Security Number Spouse's Social Security Number <br />26991489 X❑ Register of Deeds 1E] County Clerk 507 -03 -4499 <br />Lien Serial Number Lien Type - Date of Lien County <br />0891601314, E Original E Continuation E] Corrected 08/10/1989 -HALL <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />Street Address <br />City <br />Tax <br />Category <br />Number <br />sign <br />here <br />Name <br />DON HATCH <br />Street or Other Mailing Address <br />504 WEST SEVENTH STREET <br />State Zip Code City State Zip Code <br />GRAND ISLAND NE 68801 <br />Tax Reriod ( _ Date of ' Amount of Tax ( Penalty <br />1984 1 05/16/1989 1 11,065.41 1 2,766.35 <br />Interest j Additions Balance of <br />Assessment Due <br />7,329.80 <br />21,1.61.56 <br />TOTAL $ 21,161-56 <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in the <br />determination of the amount shown to be due. and the taxpayer has failed to p ay the amount due after demand. If this Notice of State <br />es to continue the priority of the state's interest in the affected property of the taxpayer. <br />Revenue Agent 402 471 -5835, ,1 <br />Title Date ' Telephone Number <br />Tide Date <br />