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07/15/2003 15:55 FAX 14024714429 NEBRASKA UCC 200309057 tr 4 >a Q003/003 sn NOTICE OF STATE TAX LIEN 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 DO NOT WRITE IN or hereafter acquired. Nebraska Identification Number 35815248 Lien Serial Number 022280373 Lien Filed With ® Register of Deeds ❑ County Clerk Social Security Number �' 522 -29 -2620 Spouse's Social Security Number Len Type Date of Lien Xn Original [] Continuation Corrected 0711012003 County HALL BUSINESS NAME AND LOCATION ADDRESS Business Name TAXPAYER NAME AND MAILING ADDRESS Name RICHARD A ZUHLKE Str=ei Address Street or Other Mailing Address 415 E 12TH City Tax Category Tax Period Number 22 2001 State Zip Code Date of Amount of Tax Assessment 05129/2002 1,029.00 City State Zip Code GRAND ISLAND NE 68801 Penalty 54.70 Intarost 103.18 Additions Asseassment Due 1,186.88 TOTAL f `h State of Nebraska Is 1,186.88 in the sign here i heraby certify that the Nebraska Department of Revenue has complied with the revenue .aws o e a e 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 Ta an extension an effe tive lien, 't serves to continue the priority of the state's interest In the affected property of the taxpayer. � Revenue Agent -7-16-03 402 471 -5713 (�i of 7Prekar Signatu re Title Date Telephone Number Revenue Senior Agent � Tiiie Date Signatur