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05/20/2011 FRS 14:52 FAX 402 471 4429 UCC SECRETARY OF STATE -�-�y Hall C;� NB See �J003/004 e Jehn R Gala - UCC STL � -3 Pss: 1 A. l2011 09:30 qP1 201103�3G �.��a�s ��Q�� !�E''�E�'�i�E 1u1'W W V. FlF V RF�1 J'R•. �t�'.1Yi1'V N�TICE OF STATE TAX LIEN This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pu�suant to the revenue [aws af 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 taxpaye� or hereafter acquired. 10145362 19155596 [�X Register of Deeds []County Lien Type 04/04/2�11 �X]Original []Continuation []CoRected Hall BUSINESS NAME AND LpCAT10N ADDRESS TAXPAYER P1AME AND NlAIUNG ADDRE Mark A. Kersten t o� Other Mail►ng Address 306 N. Pine St. Apt. #1 State Category Tax Perfod Date of Numl�r Assessment 07/01 /2010 01 1 �/31 /2010 04/04/2011 01 05/01/2010 09/07i2010 06130/20'3 0 07/01/2010 21 12/31/2010 �'�� 2 � 04/0'I/2a10 09/27/2010 06/30/2Q10 XXX-XX-8597 Grand Island Ne. 68801 Amount of Tax Penalty Interest AddiUons 8alance of Assessment Due 4,200.00 840.00 105.04 5,145.04 0.00 209.06 13.93 222.99 125.00 62.50 2.34 189.84 0.00 0.26 D.02 0.28 TOTAL �$ 5,558.15 i hereby certrty tnat tne NedrasKa �epartment or rtevenue nas compuea wun me revenue �aws or cne s�ate or nenrasKa m me ae�erm�na��on or me amouat shown to be due, and the t�xpayer has faited to pay the amount due after demand. If this Notice of State 7ax l.ien is an extertsion of an effective Ifen, it serv to continue the priori f the state's fnterest in the affected property of the taxpayer. � e Revenue Agent t�s' G o/ 402 471 S1911 Pre arer's Signature Title ate T�laphon� Number here 8 . Senior Revenue Agent �- I�. // uthor¢ed Signature Title Qate ^' 4-484-1974 Rev. 2 2002 Supersedes q-494-187A Rev � aisea , � � r j i ;