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05/14/2009 THU 13:56 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall ~002/003 ~ I~ if HI:';' III [[111111 rr I~II 9909596599-1 Pss' 1 TOPINKA RICH . Filed: 05/14/2009 11:14 AM Please forward to: Nebraska Dept of Revenue 4500 Ave. I PO Box 1500 Scottsbluff, NE 69363-1500 200903745 ..~ Nebraska Dep.rtmentcf REVENUE Notice of State Tax Lien PLEASE 00 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 XXXXX9434 19400624 2006 090790112 -\-\0...\\ 03/20/2009 10/14/2008 RICH TOPINKA 648 SWAN LANE GRAND ISLAND NE 68801 'THIS NOTICE OF STATE TAX LIEN IS ISSUED BY THE NEBRASKA DEP~TMENT 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 SPECIFJ.ED ABOVE AND REMAIN UNPAID AFTER DEMAND. THESE TAXES CONSTITUTE A LIEN IN THE COUNTY FOR PROPERTY BELONGING TO THE TAXPAYER OR HEREAFTER ACQUIRED. AMOUNT OF TAX. . . . . . . . . . . . . 38/377.00 PENALTY . . . . . . . . . . . . . . . 9 I 594. 25 INTEREST (COMPUTED TO :5/tL/UJOc:j) . . 5,95'/.1/7 UNDERPAYMENT OF ESTIMATED TAX PENALTY 1/509.41 TOTAL AMOUNT DUE . . . . . . . . . . . .. . SS,I/l./o.13 I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE ~S 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 ~XT. SIaN OF AN EFFECTIVE LIEN IT SERVES TO CONTINUE THE PRIORITY OF THE STATf t S ~TE1EST IN THE AFFECTED PROPERTY OF THE TAXPAYER. . .. . ~k. .. 'r;d,).. ~ a{J~ ..... 5/1'1:-lfli ./(~~).~.2.r.l~ RIS NAtURE TIT~ zr"~ ~~/TELEPHONE TiT'if..~ .. t~f... . . . . . IITfS fTtrIIl ~/ '