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06/17/2009 4~1En 14:45 FAX 402 471 4429 UCC SECRETARY QF STATE yyy Hall D`~ Please forward to: 2 0 0 9 0 4 8 7 6 Nebraska Department of Revenue 4500 Ave Y PO Box 1500 Scottsbluff, NE 69363-150Q ~~ nehra9ka department o< revenue X002/007 NE 5~e e! Siets Jahn A ONa - llCC STL 9909599782-3 Pgs: 1 VONdHLEN RONRL~ F Filed: 06/77/2009 08:34 HM Notice of State Tax Lien PLEASE 00 NOT WRITE IN THIS SPACE INDIVIDUAL INCOME TAX SOC. SEC. N0. 7683 NEBR. TDENT. NO. 40431630 SPOUSE SOC. SEC. N0. TAXABLE YEAR ~ 2004 LIEN N0. 0!63260062 ' COUNTY HALL RONALD F VONOHLEN DATE OF NOTICE 11/22/2006 1911 S SYI.V/4-N DATE OF ASSESSMENT Q9/12/2006 GRAND ISLAND NE 68801 THIS NOTICE OF STATE TAX LIEN IS ISSUED BY THE NEBRASKA DEPARTMENT 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 SPECIFIED ABOVE~AND REMAIN UNPAID AFTER DEMAND. .THESE TAXES CONSTITUTE A LIEN IN THE COUNTY FOR~FROPERTY BELONGING TO THE TAXPAYER OR HEREAFTER ACQUIRED. AMOUNT OF TAX . 196.00 PENALTY . 9.80 INTEREST ( COMPUTED ~ TO {~ +1~ ~Z,ppc~ ) SS•99 TOTAL AMOUNT DUE . 261.19 T HERESY 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 FATLED~TO PAY THE AMOUNT DUE AFTER DEMAND. IF THIS NOTICE OF STATE~TAX LIEN IS AN EXTENSION OF AN EFFECTIVE LIEN IT SERVES TO CONTINUE THE PRIORITY OF THE ATE'S INTEREST IN THE AFFECTED PROPERTY OF THE TAXPAYER. .~.~ ... ........~~ ......... ~/rs/fir. l~~C~~3~:-cz~ ., .R ARER'S IGI~TURE TITLE DATE/TELEPHONE AUT•ORIZED SIGNATURE TITLE .~ DATE ~rnsT