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03/26/2007 15:38 FAX 14024714429 NEBRASKA Dee ~ 002/003 ~, 200702377 9917S02321-8 pss: 1 'RODENBAUGH KEVIN N, ':Filed, 0312612007 03:06 ~ Please Return Original Copy to the Nebraska Dept. of Revenue at 200 South Silber, North Platte, NE 69101 ar f11l1llM~ dONikniiII -or ,.,.,.. NOTICE OF STATE TAX LIEN 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 afte'r 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 281'90351 - . ,- ~ ,~., ,-..~. ~ ", .,. .. Lien Serial Number Lien Filed With Social Security Number Spouse's Social ,Security Number,:. 625109:18' . .. ". !KI RE\9Isi~r of Deeds' ,0 cou~ty Cieri< -- 506,..94.-:4862 : Oqt~ qf Lien ' " .-- Lien Type.. Coun~ i, ' '. " 03/21/2007 IKI,Original D Continuation o Corrected HALL ... . . ., r BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS I Business Name Name Kevin N. Rodenbaugh Street Address Street or Other Mailing Address ,237 N Ruby City State Zip Code City Slale Zip Gode Grand Island NE 68803 ~ Tax 1 Category Tax Period Date of Amount of Tax Penalty Interest AddItions Balance of Number Assessment Assessment Due 22 2005 05/17/2006 275.00 13.75 16.57 305.32 TOTAL $ 305.32 sign lJlo here .. 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 Tax Lien' n extension of an. effecli e lien, it serves to continue the priority of the state's interest In the affected property of the taxpayer. - Revenue Agent 3- t / -tJ1 308 535-8294. Tille Date Telephone Number 5'-d:J'"() 1 Date ~...II9~-197~ R..v. 2-2002 SUpll"odo$ ~...IIB4-197~ Rev, 10.1995 Revenue Supervisor Title