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08/27/2008 WED 14:30 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall 14J002/004 ~ 200807442 9908569462-7 PllS, 1 BOEHLE BRAIAN K Filed, 08/27/2009 10,23 AM ~ ~...........kll' ;r)I01:I>o:,nrnibn't ;(J~ REVEINiUE '''''''VIr..... . ,'......IllU...''''...'IlIDV u..c..c.. CO~ This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the revenu~ 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 ac uired. Nebraska Identification Number Federal Identification Number 36441953 Lien Serial Number Lien Filed With [&I Register of Deeds Lien Type 02/19/1999 o Original I:&IContinuation BUSINESS NAME AND LOCATION ADDRESS Business Name 990500006 Social Security Number, o County Clerk XXX-XX-5950 Spouse's Social Security Number Date of Lien County o Corrected HALL TAXPAYER NAME AND MAILING ADDRESS Street Address Name BRIAN K BOEHLE Street or Other Mailing Address 1325 WOODMOOR DRIVE City ae Zip Code City State Zip Code MONUMENT CO 80132 Penalty Interest Additions Balance of Assessment Due 96.99 819.48 2,856.34 Tax Category Number Tax Period Date of Assessment Amount of Tax 22 1993 01/05/1999 1,939.87 TOTAL $ 2,856.34 I hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State 0 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 ntinue' th~ pri ity of the state's interest in the affected property of the taxpayer. REVENUE AGENT Q 122-1 ~ 402471-5928 sign Title r ~ Telephone Number here /.(,/(,:~o'u ~ ~ )~.,.ev~.Ujl 1?~ zL~8 /~.. - I' Date SEE ATTACHM~"""" _. ,.,.",_.....,,,. - ,.,'" cP