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09/08/2004 11:15 FAX 14024714429 NEBRASKA UCC 1&02/007 <br />MA1111 <br />Please return to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2� ST STE 460 <br />GRAND ISLAND NE 68803 <br />Ir <br />data" <br />do" <br />otro+r,Wo <br />01:30 PAM <br />200408952 <br />NOTICE OF STATE TAX LIEN <br />PLEASE DO NOT WRITE 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 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 Federal Identification Number Social Security Number <br />8896631 El Register of Deeds E] County Clerk 71 -0897371 <br />Lien Serial Number Lien Type Date of Lien County. <br />2:j QOriginal,E]Continuatlon ❑Corrected 09/01/2004 Nall <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name" Name <br />IBUSOL, INC. <br />Street Address Street or Other Mailing Address <br />1004 N Diers Ave <br />City State Zip Code J City State Zip Code <br />I C,ranrllclanrf AIG r1ann'l <br />Tax <br />Category <br />Tax Period <br />I <br />Date of <br />Amount of Tax <br />Penalty <br />Interest <br />Additions <br />Balance of <br />Number <br />Assessment <br />Assessment Due <br />01 12/01 /2003- 08/04/2004 8,369.42 1,471.60 232.14 10,073.16 <br />05/31/2004 <br />21 1010112003- <br />12/31/2003 05/12/2004 -0- 159.19 13.26 172.45 <br />21 01/01/2004- 06/25/2004 1 -0- 122.77 15.14 137.91 <br />03/31/2004 <br />TOTAL $ .10,38-3.52 " <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 pay the amount due after demand. If this Notice of State <br />Tax'Lien is an extension of an effective lien -it serves to continue the priority of the state's interest in the affected property of the taxpayer. <br />Revenue Agent `� > Q 308 385 -6074 <br />sign Preparer's Signature Title Date Telephone Number <br />here Do. Revenue Senior Agent / <br />Authorized i Title Da <br />-- �rc <br />