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06/08/2004 16:07 FAX 14024714429 NEBRASKA UCC IM 002 It n�brssrc� uo�nllsent Of raWo 200405672 NOTICE OF STATE TAX LIEN PLEASE DO NOT WRITE 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 ac uired. Nebraska Identification Number Lien Filed With Federal Identification Number Social Security Number 9076352 x❑ Register. of Deeds ❑ County Clerk 47- 0727144 Lien Serial Number Lien Type Date of Lien County C6 Original Q Continuation D Corrected 06/07/2004 Hall BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name Name GOSAN, INC. DBA SUPER BOWL Street Address Street or Other Mailing Address 1010 E Bismark City State Zip Code City State Zip Code Grand Island NF 68801 Tax Category Tax Period Date of Amount of Tax Penalty Interest Additions Balance of Number Assessment Assessment Due I 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, at d the taxpayer has failed to pay the amount due after demand. If this Notice of State Tax Lien is an extensio of an effective lien, it serves to continue the priority of the state's interest in the affected property of the taxpayer. Revenue Senior Agent 7 308 385 -6073 reparer's i a, e I Title Date Telephone N ber Revenue Supervisor d %A oriz�e Siam re I Title e 4- 494 -1974 Rev.; -2002 Supersedes 4 -494 -1974 Rev. 10.1995 r�- G`