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12/10/2004 12:39 FAX 14024714429 NEBRASKA UCC V 200411984 1� 003/003 Or NOTICE OF STATE TAX LIEN �IM+ett,Mrl. 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 acquired. Nebraska Identification Number Federal Identification Number 34669183 Lien Serial Number Lien Filed With Social Security Number Spouse's Social Security Number 32270680 QX Register of Deeds E] County Clerk 508 -17 -7246 Date of Lien Lien Type County 12106/2004 E] Original 11 Continuation � Corrected HALL BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name Name ROBERT E CRANSTON Street Address Street or Other Mailing Address 1414 ST PAUL ROAD APT 74 City State Zip Code City State Zip Code (;RAAlrI ICI Anlr) nrr- Tax ' IN" OODU I Category Tax Period Date of Amount of Tax Penalty Interest Additions Balance of Number Assessment Assessment Due 22 2002 05123/2003 343.00 32.15 33.89 409.04 j I j + I TOTAL I$ 409.04 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, and the taxpayer has failed to pay the amount due after demand. If this Notice of State r Tax Lien i an extension f an effective lien, it serves to continue the priority of the state's interest in the affected property of the taxpayer. j JA REVENUE AGENT (p Q 402 471 -5835 sign Prepar s S gnature Title Date Telephone Number here ► �5;, "oA /,;? -6 -Q y A thorized Sign ure Title Date . 4.494 -1974 Rev. 2 -2002 Supersedes 4 -494 -1074 Rev. 10,1896