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02/02/2010 TUB 16:00 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Ha11 V~ 201000748 Please forward to: Nebraska Department of Revenue 4500 Ave I PO Box 1500 Scottsbluff, NE 69363-1500 N~ ska Department of RE1/ENllE vvww,ravenue.ne.gov 11003/004 Ni SAC of 54Mo John q Gel^ IICC STL sslsl3isses-s aaS: t SLOAN DriNIEL G Filed: 02/02/2070 09:52 AM NOTICE OF STATE TAX LIEN This Notice of State Tax Lien is issued by the Nebraska pepattment 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 are 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 properly belonging to the taxpayer or hereafter acauired. 26253941 11035604 ®Register of Deeds ~l:aunty 01/2812010 ®Original ~Gontinuation BUSINESS NAME AND LOCATION ADDRESS XXX-XX-7691 []corrected. HALL TAXPAYER NAME AND MAILING ADDRE55 DANIEL G SLOAN 2636 N SAINT PATRICK AVE APT 6 GRAND ISLAND NE 68803-1312 Category Tax Period Date of Number Assessment 22 2007 05/21/2008 322-07 Interest Additions 42.38 ,, :.,~rw~~'`:=.:. ~, TOTAL ~ $ 322.07 avenue Agent 01/28!2010 (308)632-1206 sign ignature Title to elephane bar here ^ Revenue Su ervisor 01/28/2010 Authorized Sig ure liUe ~ Amount of Tax ~ Penalty 235A0 I 44.69 M1,.~...., w~ ~~~7 u ~~ u ~~ ~.wicana u~,au unerx or rcevenue nas COntpuea YVI[h the revenue laws of the State of Nebraska iri the determination a I amount shown to be due, and the taxpayer has tailed to pay the amount due after demand. If this Notice of State Tax Lien Is an extension of an effec#ive lien, it se cai,tinue the p ty of the state's interest in the affected property of the taxpayer, - a e 4.491-1871 Rev. 2.7QOY Supersedes 1.491.1974 Rev. iD•1995 Balance of Assessment Due