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07/16/2009 TH^ 14:34 FAX 402 471 4429 UCC SECRETARY OF STATE ~y~ Hall <br />Please forward to: <br />Nebraska Department of Revenue <br />4500 Ave I Po BOx 1 soo 2 0 0 9 0 5 8 2 7 <br />Scottsbluff, NE 69363-1500 <br />~ooz/not <br />ME Sec ai 5{ske Jehn A 6ele - UC[ s?l <br />9909802309-7 Pas: 1 <br />DADEY NANCY B <br />Filed: 07/16/2009 10:53 AP1 <br />Nebraska Depa+tment of <br />REVENUE NOTICE OF STATE TAX LIEN <br />www.revanue.ne.gov <br /> P DO NOT WRITE IN TWI PAGE <br />This Notice of State Tax~.Lien is issued by the Nebraska Department of <br />Ftevenu®Tortlnpaidta~es.pyrs~~t~t`tvaharev[snyelr~~~ct:~p~e-~ate.~_:. _ .., .~; .:__._ <br />•Nebraska.'Notlce is hereby given tl!-at taxes including penalties and <br />interest, which are shown below 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 properly belonging M the taxpayer <br />or hereafter ac uired. <br />Nebraska Identification Nu r Federel Identification Number <br />34107592 <br />Lien Serial Number Lien Flied With Soria Security Number Spouse's 5oa Secunty umber <br />82140076 ®Register of Deeds County Ck~rlc XXX-XX-9040 <br />Date of Lien Lien ype County <br />07/14/2009 ®Original Continuation ~Carreded HALL <br />BU51NES3 NAME AND LOCA TIpN ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br /> NANCY B DADEY <br /> 718 OAK STREET <br /> GRAND ISLAND NE 68801 <br />ax <br />Category Tax Period Date of Amount of Tax Penalty Interest Additions Balance of <br />Number Assessment Assessment Due <br />22 2006 10/18/2007 980.51 160.85 319.02 1,460.38 , <br /> <br /> <br /> <br /> <br /> TOTAL $ 1,460.38 <br />I hereby certify that the Nebras ka Department of Revenue as complied with the revenue laws of the State of Nebraska in the determination the <br />amount shown to be dr~nd t he taxoavechas f ailed to Dav dre amount due after demand. If this Notice of State Tax lien is an extension of an <br />effective lien, it d'COrttinu the p of to state's irderest in the affected properly aF the taxpayer. <br />avenue Agent 07!1412009 (308)632-1206 <br />sign r e Date Tel umber <br />here ^ Revenue 5u elvisor 07/14/2009 <br />Authorized gnat Title Date <br />4-48M1974 Rov. 2.2002 Suporwdas 4~49F~1974 Rar.10.7995 <br />~` ~ <br />