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01/21/2010 THU 15:1$ FAX 402 471 49;29 UCC SECRETARY OF STATE ~~~ Hall X004/005 Hi; Sic ni fig+q J.iM q 8~re - IICC fTl ' 8910817487-3 pgf; ~ ~. F1Nad 01~/~S%20 0 09:42 AM 201000467 Nebraska Department of REVENUE NQTICE OF STATE TAX LIEN www.revenue.ne.gov This Notice of State Tax Lien is issued by the Nebraska pepartment of Revenue for unpaid taxes pursuant to the revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, which an: shown below, are due from the taxpayer specified below and remain unpaid after demand, These taxes constitute a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. 32883080 11034972 ®Register of Deeds ~Couniy Clerk! XXX-XX-2251 I XXX-XX-5743 01/15/2010 ®Original ~Continuatian BU51Nl:$5 NAME AND LOCATION ADDRESS Corrected I HALL TAXPAYER~NAME AND MAILING ADDRESS CHRISTOPHER M & JENNIFER J SINNER PO BOX 1442 EVANSVILLE WY 8263fi Category Tax Period Date of Amount of Tax Penalty Interest Additions Balance of Number Assessment Assessment Due ZZ 20D6 07/02/2009 194.00 9.70 36.72 240.42 Please return Copy to: Nebraska Dept ofRevenue PO Box 94818 Lincoln NE 68509 TOTAL ~ $ 240.42 ~~..~,.,,r ..~~~~r ~~~< <~~~ ~.~w~~~na vepa~unem or rcevenue nas Cflmpuea NAVI the revenue laws of the State of Nebraska in the determination of the amount Shawn to be due, and the taxpayer has tailed to pay the amount due after demand, If this Notice at Slate Tax Lien is an extension of an ettective lien, tt serv s to continue the priority of the state's interest in the affected property of the taxpayer. ^ ~ Revenue Agent 01/15!2010 (402W71~928 SI~Ct Pr e s ignature Title Date Telep one Number here ^ Revenue Su eroisor 01/15/2010 A prized Signatu Title Date Ii81.1871 Rev. 2-2882 Supersedes ~-49~-1971 Rav. to-1885