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Q3(31/2Q11 THU 14:29 FAX 4Q2 471 4429 UCC SECRETARY OF STATE ��� Hall <br />� <br />2Q1�0255� <br />�Q04/004 <br />NE Sec af 5lete John R Gsle - ucC STL <br />9911656793-1 Pss: � <br />MEYER GRRY F <br />Filed: 03/31l2011 10:41 RM <br />�. <br />hJebraska Department of <br />REVENUE NOTICE OF STATE TAX LIEN <br />www.revenuo.ne.gov <br />This Notice aE State Tax Lien is issued by the Nebraska Department of <br />Reve�ue for unpaid taxes pursuant to the revenue taws of the state of <br />Nebraska. Notice is hereby given that taxes tnctuding penalties and <br />interest, which are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These taxes const+tute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereafter acquired. __ <br />46326588 <br />11153721 �Register ot Deeds [�County Cle�c XXX-XX-0027 <br />)ate of Lien Lien Type County <br />03l29I2011 �Original �Continuatian �Corcected HALL <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAIIING ADDRESS <br />GARY F MEYER � <br />1221 W JOHN <br />GRAND ISLAND NE 68803 <br />Category Tax Period Oate of Amount of 7ax <br />Number Assessment <br />22 2000 OM08/2009 72.00 <br />22 2005 03/20/2009 295.00 <br />Penalty <br />18.00 <br />73.75 <br />Interest Additions <br />47.99 <br />92.93 <br />4.49 <br />Balance of <br />�essment Due <br />137.99 <br />461.68 <br />26.99 <br />22 � 2Q06 � 03I20I20Q9 � 18.00 � 4.50 <br />TOTAL I $ 626.66 <br />1 hereby certify Ihallbe Nebtaska Department of Revenue has complied with the revenue laws or me State or neorasKa m me ae�ermmauvn or u�e <br />amouM shown tu he due, and khe taxpayer has fai{ed lo pay the amount due after demand, if this Notice of State Tax Lien is an e�4ension of an <br />effective lien, il serves to tinue the �'o ' f e sl e's interest in the affected property of the ta�ayer. <br />� Revenue Agent � ` 2 '^ (308)632-1203 <br />sign Prepar S' n t re TiUe Date Telephone umb <br />here ► Revenue Supervisor j Z� �f <br />Authorized ure Title Date <br />4-�94-1974 Rav. 2-2002 Supersedes N9�-187� Rer.1a1995 <br />�• . <br />