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05/10/2010 MON 15:08 FA}t 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />2oloo3iss <br />Please forward to: <br />Nebraska Department of Revenue <br />4500 Ave I PO Box 1500 <br />Scottsbluff, NE 69363-1500 <br />-^ N~ ska department of <br />REVENUE <br />w.ww.revenuo.ne.gov <br />X002/006 <br />NE Sec of 5tete John A Gslo -UGC SiL <br />8910626786-t3 Pas : 1 <br />FRiiIfEN ERIC <br />Filed: 05/10/2010 10:2fi AM <br />NOTICE OF STATE TAX LIEN <br /> PLEASE DO NOT WRITE IN THIS SPACE <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 spet;ified <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 wired. <br />Nebraska Identificatlan Num r Federal I entification Num <br />28319575 <br />Llen Senal umber Lien Filed With peal Security Number Spouse's Social Security Number <br />11039314 ®Register of Oeeds County Cletk XXX-XX-5806 XXX-XX-1140 <br />Date of ien Lien Type County <br />05/06/2010 ®original Continuation Corrected HALL <br />BU5INESS NAME AND LOCA TION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br /> ERIC 8~ DIANE FRAUEN <br /> 285 D ROAD <br /> GRAND ISLAND NE 68801 <br />Tax <br />Category Tax Period Dats of Amount of'fax Penalty Interest Additions Balancs of <br />Number Assessment Assessment Due <br />22 2005 03/05/2008 2,1$1.00 1,035.25 906.23 4,122.48 <br /> <br /> <br /> <br /> <br /> TOTAL $ 4,122.48 <br />I hereby certi ty that tba,(Vebras ka Department of Revenue has complied w ith the revenue laws of the State of Nebraska in the dP tPrminalinn nr the <br />amount shown to d e, and the t r has failed to pay the amount due after demand. If this Notice of State Tax Lien is an extension of an <br />effective lien, it se s to contin a lh ority f the state's interest in the affected property of the taxpayer. <br />(• Revenue Agent 05/Ofi/2010 (308)632-120fi <br />SIC! r' gnatu Title Dale elephone Number <br />it@rL ~ Revenue Su t3tvisar 05/06/2010 <br />prized re Title Date <br />494-1974 kev. Y-2UG2 Supersedes 4-494-1974 Rev. 1p-1995 <br />~' <br />