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O1/28/2011 FRI 14:31 FAX 402 471 4429 UCC 58CRETARY OF STATE ~~~ Hall <br />, `. <br />2olioo�s� <br />�ooa�ooz <br />of St+te John A G�la - UCC STl <br />I <br />a9�ea—s �:: , <br />DOl3GLq5 <br />01/28/2011 08:22 AM <br />�+ekaarar,,� �rew�,r�wrr.c a+r <br />��'''E�1'�E NOTICE OF STATE TAX L1EN <br />11ViPMW.R'Y+/�QYti►O.F O'.�10Y <br />This Notice of State Tax Lien +s issued by the Mebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue taws of;the state of <br />Nebraska. Notice 1s hereby given that taxes inciuding pe�alties and <br />interest, which are shown below, are due from the taxpayer specified <br />below'and remain unpaid after demand: 7hese'taxes constitute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter acquired. _ <br />8537054 <br />11151363 �X Registe� of Deeds []County <br />Lien 7ype <br />12/18/2010 �]X Original �Continuatio� <br />BUSINESS NAME AND LOCATION ADDRESS <br />Category 7ax Period Date of <br />Number Assessment <br />01 08/01 /2009 43/08/2009 <br />10/31 /2009 <br />12/01/2009 <br />01 � 2�31/2009 03I08/2009 <br />01 11101 /2009 12/18/2010 <br />11I30/2009 <br />�� 01(01/2010 12/18/2010 <br />07/31/201 p <br />Amount of Tax <br />0.00 <br />0.00 <br />78.00 <br />557,00 <br />47-0836131 <br />XXX-XX-4939 <br />[]Corrected HBII <br />TAXPAYER NAM AND M AILI NG ADDRESS <br />pougias Avila <br />; or Other Malling Address <br />603 W. 4th St. <br />State Zip Code <br />Grand Island Ne. 68801 <br />Pe�alty Interest Additions Balance of <br />63.85 1.96 <br />25.00 0.05 <br />32.80 3.83 <br />230.70 15.72 <br />TOTAL <br />Assessment Due <br />65.81 <br />25.05 <br />114.63 <br />803.42 <br />$ 1,008.91 <br />{ hereby certify that the Nebraska Department of Revenue has complied wrth the revenue iaws ot me aca�e or ne4rasRa n� �ne ues�a�������au��� �, ���� <br />amount shown to be due, and the taacpayer has failed to pay tt+e amount due aRes demand. If this Notice of State Tax Lien is an extension oi an <br />effective lien, ft serv to continue the prior' f the state's interest in the affected property of the taxpayer. <br />e � Revenue Agent o i �,?G ,�o % 4Q2 471-G067 <br />sign Prep rer's igna ure Title Date Telephone Numbe� <br />here e Senior Revenue Agent / � l� <br />ut rized gna ur Titfe Date <br />4� 1 9 4- 1 9 7 4 R e v. 2- 2 0 0 2 S u p e r s e d e s 4-0941974 Rev.141995 <br />