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10/23/2007 TUE 15:16 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall 121003/003 \)f0 200709097 .I~I "f ;1' fIll 'I 9907530732-3 Pgs; 1 HOLDER L.ARRY J F11.d, 10/23/2007 02:12 PM Please forward to: Nebraska Dept of Revenue 4500 Ave I PO Box 1500 Scottsbluff, NE 69363-1500 nebraska department of revenue Notice of State Tax Lien- IIr PLEA$E DO NOT WRITE IN THIS SPACE INDIVIDUAL INCOME TAX soc. SEC. NO. NEBR. IDENT. NO. SPOUSE SOC. SEC. NO. TAXABLE YEAR LIEN NO. COUNTY DATE OF NOTICE DATE OF ASSESSMENT 505525695 '11621435 2005 070330Q58 HALL_ 02/02/2001 10/20/2006 LARRY J HOLDER 515 W 16TH GRAND ISLAND NE 68801 THIS NOTICE OF STATE TAX LIEN IS ISSUED BY THE NEBRASKA DEPARTMENT OF REVENUE FOR INDIVIDUAL INCOME TAX PURSUANT TO THE REVENUE LAWS OF THE STATE OF NEBRASKA. NOTICE IS HEREBY GIVEN THAT INDIVIDUAL INCOME TAXES INCLUDING PENALTIES AND INTEREST, WHICH ARE SHOWN BELOW ARE DUE FROM THE TAXPAYER SPECIFIED ABOVE AND RE~INUNPAID AFTER DEMAND. THESE TAXES CONSTITUTE A LIEN-IN THE COUNTY FOR: PROPERTY BELONGING TO THE TAXPAYER OR HEREAFTER ACQUIRED. " AMOUNT 'OF TAX . ~ . . . . . . . . . 343.00 PENALTY . . . . . . . . . . . . . . . . . .' . 25.15 INTEREST (CO~PUTED TO 02/02/2007) . . . . . 17.14 TotAL AMOUNT DUE . . . . . . . . . . . . . 385.29 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 IS AN EXTENSION OF AN EFFECTIVE LIEN IT SERVES TO CONTINUE THE PRIORITY OF THE STATE'S INTEREST. IN THE AFFECTED PROPERTY' OF THE_TAXPAYER. . ~(JII.f'I(Fl./ ~Qf)~~7;--J.~ DATE/TELEPHONE .. (l>/(r49:. ...... DA.;t~ ~