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07/30/2008 WED 15:06 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall 14J003/003 & HE s.. .r Sht. J.hn II Gal. - uee STL 200806565 9908567209-9 pgs: 1 ECHTENKAMP LEE Filed, 07/30/2008 11,40 AM ~ N..brlilt.k;ll D_.,l'In>oIorn~' :REVEN:UE """'_.If .......n..........'lli..'V 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 after demand. These taxes constitute a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. Nebraska Identification Number Federalldentificalion Number 9065628 Lien Serial Number Lien Filed With ~Isocial Security Number Spouse's Social Security Number ) ~o080ati) 1XI Register of Deeds Dcounty Clerk XXX-XX.8945 Date of Lien Lien Type County 07/25/2008 1XI0rlginal DContinualion o Corrected HALL BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name Name LEE ECHTENKAMP Street Address Street or Other Mailing Address PO BOX 186 City i::itate Zip Code City State Zip Code CARlO NE 68824 Tax Category Tax Period Date of Amount of Tax Penalty Interest Additions Balance of Number Assessment Assessment Due 01 01/01/2004- 08/01/2005 0.00 186.00 95.63 281.63 12/31/2004 01 01/01/2005- 08/01/2006 463.00 233.00 192.01 888.01 12/31/2005 01 01/01/2006- 07/01/2007 1,455.00 291.00 174.44 1,920.44 12/31/2006 TOTAL $ 3,090.08 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 selVes to continue the priority of the state's interest in the affected property of the taxpayer. 402 L{7J -57dj ;.f.ws;~ Te~h;; ";;7 Title Date 4-'194-19701 Rev. 2.2002 Supersedes 4-'194-1974 Rev. 10.1995 sign here ~