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<br />12/23/2008 ~UE 14:25 FAX 402 471 4429 UCC SECRE~ARY OF S~A~E ~~~ Hall <br /> <br />121002/007 <br /> <br />rP <br /> <br /> <br />Please return to: <br />STATE OF NEBRASKA <br />'DEPARTMENT OF REVENUE <br />1811 WEST 2ND ST STE 460 <br />GRAND ISLAND NE 68803 <br /> <br />9908580222-4 pgs: 1 <br />PARAOtSE TANNING, L.L.C. <br />Filed: 12/23/2008 11 :09 AM <br /> <br />200810356 <br /> <br />~ <br />N'..f'lIII~l!. D~m:1Olf <br />REVENUE <br /> <br />................bV................._ <br /> <br />NOTICE OF STATE TAX LIEN <br /> <br /> PLEA$E DO NOT WRITE IN THIS SPACE <br />This Notice of State Tax Lien is Issued by the Nebraska Department of <br />Revenue 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,whieh-ar-e-shown-beJow,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 property belonging to the taxpayer <br />or hereafter acquired. <br />Nebraska Identification Number Federa/ldentification NIJmber <br /> 9478000 20-1715810 <br />Lien Serial ffi\ll~1 0 O~ lien Filed With Social Security Number /spouse's Social Security Number <br />00 Register of Deeds DCounty Clerk <br />Date of Lien \ Lien Type County <br /> 12/17/2008 OOOriglnal OContinuation o Corrected . Hall <br /> BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />Business Name Name <br /> Paradise Tanning, LLC. <br />Street Address Street or Other Mailing Address <br /> . 1451 North Webb Road <br />City ::state Zip Code City State Zip Code <br /> Grand Island NE 68803 <br />Tax <br />Category Tax Period Date of Amount of Tax Penalty Interest Additions Balance of <br />Number Assessment Assessment Due <br />01 03/01/2007- 10/08/2008' 5,736.53 1,568.08 638.93 7,943.54 <br />08/31/2008 <br /> TOTAL $ 7,943.54 <br /> <br />1 hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska In the determmatlon of the <br />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 <br />effective lien, it serves to continue th riorily of the state's intere in the affected property of the taxpayer. <br /> <br />/.;2/)7/ ~f)/)f <br />Ti ~ . Date _ I . Telephone Number <br /> <br />4.A'7/~ .s;~,a.o-""'''''''i ~ /' J?!J'tfnfl <br />Tifle -- . - D'ate I <br />4-494.1974 Rev. 2-2002 Supersedes 4-494.1974 Rev. 10-1995 <br /> <br />sign <br />here <br /> <br /> <br />308 385-6073 <br /> <br />v <br />