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04/23/2004 16:16 FAX 14024714429 NEBRASKA UCC IA 002/004 Ir 200404075 NOTICE OF STATE TAX LIEN This Notice of State Tax Lien is issued by the Nebraska Department of PLEASE DO NOT WRITE IN THIS SPACE 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 13758497 0 Register of Deeds o County Clerk 507 -40 -9751 505 -30 -2329 Lien Serial Number Lien Type Date of Lien County 089252098 � Ori Inal 0 Continuation Corrected 01/01/1990 HALL . BUSINESS NAME AND LOCATION AD S TAXPAYER NAME AND MAILING ADDRESS Business Name Name EDWIN E & ARDITH L KOKES Street Address Street or Other Mailing Address 3210 EAST GREGORY STREET city State Zip Code City State Zip Code GRAND ISLAND NE 68801 Category Number Tax Period Date of Amount of Tax Assessment Penalty Interest Additions Balance of 22 1982 08/15/1989 3,581.21 179.06 3,369.49 Assessment Due 7,129.76 22 1983 08/15/1989 891.20 44.56 713.39 1,649.15 22 184 08/15/1989 2,327.26 116.36 1,537.12 3,980.74 TOTAL $ 12,759.65 1 hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska in the 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 T ' Lien s an extenslon of an effective lien, it serves to continue the priority of the state's interest in the affected property of the taxpayer. Revenue Agent 402 471 -5835 sign Prepar Signature Title Date Telephone Number C_ / ' here Authorized Sign#re -Title Date