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Notice of State Tax Lien Mak a t aRead on fam a m@ Lien sarlei Number Lien Type oat* Social Security Number Original o] tg5 n Reew.t 1 -9 -85 g5.,.. 000,1"3 °k Nebraska LO. No. County Lien Filed VAth Spouse %Social Security ® Register of Otexis Number � 4 li County Clerk ' BUMNIESS N^Mg AND LOCATWi ADOREIM TAXPAYER NAME AND MAtLnN oushus No" Name Dads r South Inc. Dads Ligggr South Inc Stnrk Street or Other Mailing. Address L40 %N Locust 1404 South Locust \� city State Zip Code City State ZIP: Code - lslan4i, NE 68801 Grand Island NE 68801 This Notice of State Tax Lien is sued by the Nebradw Department of Revema for unpaid taxes pumum to the { revenue laws of the sate of Nebra" Notice is hereby given that taxes inducting penalty and interest, which we shown below, are due from the taxpayer specified above and remain unpaid after demand. These tuxes constitute a lien in the county for real and personal property belon&g to the taxpayer or hereafter acquired. i as mAROaat of Tax penalty Itw AMltohcowwv Tax P1111110111 A t selom of I Number 05-01 -84 thru 01 05 -31-84 12-19-84 1015.04 31.39 77.47 1123.90 06-01-84 thru 01 06 -30-84 112-19-84, 1209.43 37.41 77.93 1 1 1324.77 07 -01-84 thru 01 07 -31 -84 12 -19 -8 1239.08 38.32 65.11 1342.51 TOTAL I $ 3839.49 thereby certify that the Nebraska Department of Revenue has complied with the revenue taws of tat* State of Nebraska in the dater - m1nation of the amount shown to be due. and the taxpayer has failed to ley the amount due after demand. If this Notice of State Tax Urn Is an extension of an effective lien it serves to Continue the priority of the state's Interest an the affected property of the taxpayer. a _ Revenue Agent 1 -9 -85 r4eperx %545 inn The Dab ial Actent 1 -9 -85 Authorized Title Date FOR COUNTY OFFICIAL'S USE DEPARTMENT OF REVENUE - Whits and "clenrod Copies TAXPAYER — Pink Copy In Am COUNTY OFFICE — Canary Copy 449474 Rev. 7.91 Supersedes 4. 494.74 Rev. S-40 U K W