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03/14/2005 10:05 FAX 14024714429 NEBRASKA UCC <br />l <br />20050217'7 <br />Or <br />"obn,w <br />aeptnmenl <br />of rOvMMw <br />Q002/002 <br />sip <br />i <br />Pas: , <br />03:57 PM <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 Federal Identification Number <br />8896631 <br />Lien Serial Number Lien Filed With Social Security Number Spouse's Social Security Number <br />o5l nzl _ a EI Register of Deeds County Clerk 508 -17 -3208 <br />Date of Lien Lien Type- County <br />02/15/2005 - [E original ❑Continuation Corrected <br />BUSINESS NAME AND LOCATION ADDRESS TAXP_A,. EB NAM/ AND•Mi /LING ADDRESS <br />Business Name Name <br />Wesley M Encmget...__. _- <br />Street Address Street or Other Mailing Address <br />4613 West Prairie Road <br />City State Zip Code City State Zip Code <br />Grand Island NE 68803 <br />Tax <br />Category <br />Tax Period <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- 02/15/2005 15,497.42 2,412.50 654.49 18,564.41 <br />09/30/2004 <br />21 04/0112004- 02/15/2005 2,327.12 310.08 60.50 2,697.70 <br />09/30/2004 <br />1 I ' TOTAL I $ 21,262.11 <br />I hereby certify that the Nebraska Department df Revenue.has complied Huth 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 Notide cTStAte" <br />Tax Lien is an exte sion a0fri effective lien, it serves to continue the priority of the state's interest in the'affected property of the taxpayer. �! f <br />Revenue Senior Agent .Q 308. 38.5 -6073 <br />sign Signatu l Title <br />Date Telephone Number <br />Pre <br />here Revenue Supervisor to <br />A <br />u re Title <br />t 4494 -197a Rev. 2 -202 Supersedes 494.1974 Rev. 70.996 <br />