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<br />08/27/2007 MON 16:51 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />1210021006 <br /> <br />& <br /> <br />200707361 <br /> <br />11""'1" <br /> <br /> <br />990752311 7-0 pgs. 1 <br />~~':G 0~?~7~007 10,51 AM <br /> <br />Please return to: <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2ND 5T 5TE 460 <br />GRAND ISLAND NE68803 <br /> <br />... <br /> <br />IIr <br /> <br /> <br />NOTICE OF STATE TAX LIEN <br /> <br />nOb11o$1\l <br />.,.,,""'0111 <br />qt'~ <br /> <br />PLEASE DO NOT WRITE IN THIS SPACE <br /> <br />This Notice of State Tax Lien is issued by the Nebraska Department of <br />Re~enue for unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice is hereby given -that taxes including - penalties and <br />interest, which are shown below, are due from the taxpayer specified <br />below and remain unpaid"after demand. These taxes constitute a lien <br />In the county for real and personal properly belonging to the taxpayer <br />or hereafter acquired. ' '. . . <br />_ Nebraska Identification Number, Federal Identification Number <br /> <br />_ -08/24/2007 <br /> <br />Uen Flied With ' <br />o Regi~ter of Deeds _ Dcounty Clerk <br />Uen Type <br />~] Original DContinualion- <br /> <br />20-4841372 <br />.' <br />Social Security Number - <br />507-76-7442 <br /> <br />Spouse.s' Social Security Number <br /> <br />9809171 <br /> <br />Uen Serial Number <br /> <br />n~l ()1J()f)Lf( <br />Date of Lien <br /> <br />BUSINESS NAME AND LOCATION ADDRESS <br />Business Name <br /> <br />County <br /> <br />D.corrected Hall <br /> <br />TAXPAYER NAME AND MAILING ADDRE,5S <br /> <br />Street Address <br /> <br />Name <br />Warren Lemburg <br />Street or Other Mailing Address <br />5137 N. 190th Road <br /> <br />City State Zip Code <br />Tax <br />Category Tax Period Date of Amount of Tax <br />Number Assessment <br />01 07/01/2006~ 08/03/2007 6,780.18 <br />06/30/2007 <br /> - <br /> " <br /> <br />City' <br /> <br />Cairo <br /> <br />Penalty <br /> <br />Interest <br /> <br />601.01 <br /> <br />, 200.05 <br /> <br />-, , <br /> <br />TOTAL <br /> <br />$ <br /> <br />7,581.24 <br /> <br />. I hereby certify that the Nebraska Department of Revenue has compiled with 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 Notice of State <br />Tax Lien is an extension of n effective lien, it serves to continue the priority of the state's interest in the affected property of the taxpayer. <br /> <br />.... ,- Revenue Senior Agent , J' J 01 </ I D {_ . 308 385,-6073 <br />sIgn . .....re(. s~"'\U < TWe 001< ~"':;t;;~ <br /> <br />here II> Revenue Supervisor p. , <br />Authori Tille e ' <br />......'''........- -,,,..... ..,~ <br /> <br /> <br />