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<br />06/01/2006 15:50 FAX 14024714429 <br /> <br />NEBRASKA UCC <br /> <br />141 002/002 <br /> <br />J' <br />\j\) <br /> <br />Please return to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2ND 8T STE 460 <br />GRAND ISLAND NE 68803 <br /> <br /> <br />200604943 <br /> <br />~ <br /> <br />NOTICE O,F STATE TAX LIEN <br /> <br />l'lIlotlfUkt <br />C1*"AmllM <br />ot~ <br /> <br /> PLEASE DO NOT WRITE IN THIS SPACE <br />,This Notice of State Tax Li~n is issued by the Nebra'ska Department of <br />Revel:'ue f.or,u!1pald 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 speclfi,ed <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 acauired. - - <br /> , <br />Nebraska Identification Number Federal Identification Number <br /> 9213783 ,- " <br /> .,", J :'~ .":, <br /> , - <br />Lien Serial Number Lien Filed With. Sot,i,~1 Security Number Spouse's Social Security Number <br /> 0;>.,1 D<o (dXJ0 [!] Register of Deeds Dcounty'Cl9!t1: ' . <br /> , , ' ' ,,' <br />Date of Lien Lien TYpe .- , ,COUl1ty",' . ,- <br /> OS/24/2006 [!] Ori~,inal D Continuation D Corrected Hall_ ' <br />I BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS l <br />Business Name Name <br /> OPEN RANGE CONSTRUCTION, LLC <br />Street Address Street or Other Mailing Address <br /> p, O. Box 5472 <br />City " State Zip Code City State Zip Code <br /> Grand Island NE 68802 <br />r Tax I <br />Category Tax Period Date of Amount of Tax Penalty Interest Additions Balance of <br />Number Assessment Assessment Due <br /> 01 05/01/2005- 11/03/2005 ,1,142.79 146.57 53,73 1,343.09 <br /> 07/31/2005 <br />-- -- -- 08/01/2005- ..~..~ . .. . .- ..-- --.. --- . --,-- ...__u_ _ -". -- . ---.. - - - -- 7,531.50 ' - <br /> 01 12/30/1899 OS/24/2006 6,142.50 1,228.56 166.44 <br /> TOTAL $ 8,880.59 <br /> <br />I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the Stat.e 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 Stale <br />.. Tax L~o . '" ""~of ~~I" 1100, . ~, 10 000110"" the P"~tIly 0' the ,\.la', 101.",,, 10 lho a_" ..ope'" of the laxpay" <br /> <br />. .,. d~ ) H' Jr) Revenue Senior Agent ~I J ~f)O {, 308 385~6073 <br />slg" Preparer's Sign ture ./' Title ale ' Telephone Number <br /> <br />here' Revenue Supervisor -:;23 ~Ok - - <br />Title te n f\ <br />. 4-494-1974 Rev. 2-2002 SupersedeS 4-494-1974 Rev, 10~1995 ~ <br /> <br />