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06/15/2005 08:14 FAX 14024714429 NEBRASKA UCC <br />200505403 <br />�ear•�sic� <br />Q002/002 <br />NE S., of Sib - UCC <br />STL <br />99653997.83 -5 Pyle : 1 �: <br />TORRES REYES JR <br />Filed: 06/1412005 02 :59 PIA <br />NOTICE OF STATE TAX LIEN <br />This Notice of State Tax Lien Is issued by the Nebraska Department of PLEASE DO NOT WRITE IN THIS SPACE <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 Federal Identification Number <br />99751593 <br />Lien Serial Number Lien Filed With Social Security Number Spouse's Social Security Number <br />32620048 Register of Deeds County Cleric 505 -96 -3501 505 -15 -2679 <br />Date of Lien Lien Type County <br />06 -10 -2005 XZ Original ❑ Continuation []Corrected HALL <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />Street Address <br />City <br />Tax <br />Category <br />Number r <br />22 <br />State <br />Tax Period I Date of <br />Name <br />REYES TORRES JR <br />Street or Other Mailing Address <br />2423 S BLAIN ST <br />Zip Code City <br />Amount of Tax <br />2000 108 -05 -2003 1 310.00 <br />GRAND ISLAND <br />Penalty t Interest <br />17.05 1 96.48 <br />State <br />NE <br />Additions <br />Zip Code <br />6$603 <br />Balance of <br />sessment Due <br />423.53 <br />TOTAL $ 423.53 <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 si to be due, and the taxpayer has failed to pay the amount due after demand. If this Notice of State <br />Tax Lien is t on of a tive lien, it serves to Continue the priority of the state's Interest in the affected property of the taxpayer. <br />avenue Agent " <br />402 471 -5835 <br />sign I Preparer's signature Tifie Date Telephone Number <br />here Senior Revenue Agent _ —_Lq Sr <br />uthorized Signall Title, <br />