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12/28/2009 MON 14:44 FAX 402 471 4429 UCC SBCRETARX OF STATE ~yy Hall ia1003/007 <br />NE Sec oI Sis~a John R q~-e - {1CC STL <br />20091014 <br />Please forwazd to: 9909615233-Y Pas: 1 <br />STANGLtiR NICHOLRS K <br />Nebraska Department of Revenue Filed: 12/28/2008 11 :15 ~ <br />4500 Ave I PO Box 1 S00 <br />Scottsbluff, NE 69363-1500 <br />Nebraska Qepartment of <br />REVENUE NOTICE OF STATE TAX LIEN <br />www.revenue.ne.gov <br />PL~A$E NOT WRITE IN THIS SPA <br />This Notice of State Tax Lien is issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska, Notice is hereby.given that taxes including penalties and <br />interest, which are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These taxes constitute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter ac uired. <br />Nebraska Identlfica on under Fcdera carton Number <br />36541826 <br />Lien Sen umt~er Lien fled With ial Security Number Spouse's Saga rity Num <br />10933754 ®Reglster of Deeds ~Caunty Clerk XXX-XX-7686 <br />Date of Lien Lten Typa County <br />12/22/2009 ®Orlginal ~Continua6on ^Carrected HALL <br />BlJ$INE53 NAME AND LOCAT ION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br /> NICHOLAS K STANGLER <br /> 2222 BBLLWOOD DR APT 29 <br /> GRANp ISLAND NE 68801 <br />Tax <br />Category Tax Aerlod Date of Amount of lax Penalty Interest Additions Balance of <br />Number Assessment Assessment Due <br />22 2007 08/03/2006 118.00 5.90 12.48 136.38 <br />22 2008 05/26/2009 470.00 23.50 16.16 509.68 <br /> <br /> <br /> TOTAL $ sas-oa <br />I hereby certif y that the Nebras ka Department Revenue has complied w ith the revenue laws n fhP Sfafa of Nahraaka in o p M+rnvns6.,., .,i t-,e <br />amount shown to be e, and the taxpayer has failed to pay the amount due after demand. ff this Notice of State Tax Lien is an extension aF an <br />effective lien, it serv to conU ue riority of the state's interest in the affected property of the taxpayer. <br />Revenue Agent 12/22!2009 (308)632-12D6 <br />Slgfl re i nature .Talc Date Telep ne Number ' <br />here ~ Revenue Su ervisor 12/22/20D9 <br />Au prized re Title Date <br />4.494-1974 Rev. J-Y1102 Supers9aes 4.491-1874 Rev. ra1BB5 <br />