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03/10/2011 THU 13:59 FAX 402 471 4429 UCC SECRETARY OF STATS ��� Hall <br />� <br />�la�brasko £artMya�rtsnertl a�' <br />�E"'�'E��E <br />�v+r�uww.rrvre.vw:.u�. qv'v <br />�006/007 <br />- ucc sri <br />e: 1 <br />201101948 <br />NOTICE OF STATE TAX LIEN <br />This Notice of State Tax Lien is issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant ta the revenue laws of the state of <br />Nebraska. Notice is hereby given that taxes including penaities and <br />interest, which are show� 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 acquired. <br />9370870 <br />r ts��� <br />�Fiegister of Deeds �County <br />02/28/2011 I �X Original �Continuation <br />BUSINESS NAME AND LOCATION ADDRESS --� <br />Category Tax Period Oate of <br />Number Assessment <br />01 06/01 /2009 08/04/2010 <br />07/31 /2009 <br />01 08/01 /2009 11 /04/2009 <br />09/30/2009 <br />01 01/01/2010 05/06/2010 <br />02/28/2010 <br />01 05/01/2010 07/06/2010 <br />05/31/2010 <br />01 10/01/2010 02/07/2011 <br />12/31/2010 <br />Amount of Tax <br />7,127.59 <br />0.00 <br />0.00 <br />2,554.55 <br />0.00 <br />75-3158224 <br />[]Corrected 1 Hall <br />TAXPAYER NAME AND MAILING ADDRESS <br />, The Boat Dock, Inc <br />t or Other Mailing Address <br />3620 W. Old Hwy 30 <br />State Zip Code <br />Grand Island Ne. 68803 <br />Penalty Interest Additions Balance of <br />712.75 <br />200.26 <br />156.15 <br />255.46 <br />129.19 <br />556.39 20.00 <br />2.52 200.00 <br />5.98 <br />86.79 <br />20.8 �.�L <br />TOTAL <br />Assessment [ <br />8,416.73 <br />402.78 <br />162.13 <br />2,896.80 <br />150.07 <br />$ 12,028.51 <br />i nereny certiry mat ine nenrasua ueparunen[ or rcevenue nas compnea wi[n tne revenue iaws or me o�a�e o� rveorasKa m�ne ae�erm�nanon or me <br />amount shown to be due, and the taxpayer has failed to pay the amount due after demand. lf this Notice of State Tax Lien is an eMension of an <br />effective lien, it serve continue tbe priori the state's interest in the affected property of the taxpayer. <br />e� ,�.1,�/ � � Revenue Agent 3�a y�� ��� 402 471 <br />sign reparer's Signa ure Title Date 7elephone Number <br />here 8����,��� �,�i�� Senior Revenue A�ent � 9� /� <br />uthorized Signature Title Date <br />4494-1974 Rev. 2-2002 Supersedes 4-494-1974 Rev.10-7995 <br />� <br />