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04/22/2004 09:54 FAX 14024714429 NEBRASKA UCC tr orgWdve 200403038 10003/003 NOTICE OF STATE TAX LIEN IN THIS SPACE This Notice of State Tax Lien Is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalties and Interest, which are shown below, are due from the taxpayer specified below and remain unpaid after demand. These taxes constitute a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. Nebraska Identification Number Lien Filed With Social Security Number Spouse's Social Security Number 36786128 El Register of Deeds D County Clerk 507 -04 -9052 Amount of Tax Lien Serial Number Interest Lien Type Balance of Date of Lien County 942310183 _ [ ] Orlgkrrdl""QX Confinuafiory,--' ❑ Corrected 08119/1994 1 HALL BUSINESS NAME AND LOCATION ADD'RE'SS TAXPAYER NAME AND MAILING ADDRESS Business Name Name KYLE EICKHOFF Street Address Street or Other Mailing Address 216 E PLUM PO BOX 90 City State Zip Code City State Zip Code DONIPHAN NE 68832 Tax Category Tax Period Date of Amount of Tax Penalty Interest Additions Balance of Number Assessment Assessment Due 22 1 1993 106/04/1994 1 249.00 1 12.45 1 6.02 267.47 TOTAL I$ 267.47 1 hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in the i determination of the amount shown to be due, and the taxpayer has failed to pay the amount due after demand. If this Notice of State i -- `r- Tax Lien Js!pq extensio f an effectiv lien, it serves to continue the priority of the state's Interest in the affect d property of the taxpayer- F Revenue Agent 2 �r/-(� 402 471 - 5835" `� sign P Signature Title Date Telephone Number Y5 here Date A orized Signat'r Tide