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08/12/2011 FRx 15:03 FAx 402 471 4429 UCC SECRETARY OF STATE -�-+� Hall l� � + �� . � Netiraska Depantment af �� w�ivw. �e ve ii u b. n e: g.c v NOTICE OF STATE TAX LIEN This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid texes pursuant to the revenue laws of the state of Nebraska. Notice is hereby given that ta�ces including penalties and interest, which are shawn below, are due from the taxpayer specifled below and remain unpaid after demand. These taxes constitute a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. 44095448 11159890 �Register�Deeds �Ca�nty Clerk XXX XX-2602 Date of Uen u� Ty� c«,►,� OSN 1/2011 ��rtginal ❑Can�nuatlon []Corrected HALL BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND Category Tax Period Date of Amount of Tax Number Assassment ?2 1989 01/05/2011 2,692.18 22 2000 01/Q5/2011 � 1,608.70 22 2001 1?J03/2010 1,590.00 22 2002 12/03/2010 2,394.00 22 2003 12/03/2010 2,062.00 MICHAEL K HARRIS 4359 W CAPITAL AVE GRAND ISLAND NE 68803 Penalty 673.05 191.44 457.50 598.50 515.50 Interest I Addiaons 1,518.79 946.12 1,229.73 935.13 TOTAL �J003/004 ADDRE3S Balance of Assessment Due 5,451.78 3,318.93 2,983.62 4,222.23 3,512.63 $ 79,499.99 �� ici cuy � my u wi u m rvCtua�Ra I.KrepefUn�l� pf K@YI:IIUB f18S GOf1)pll@0 WIU'1 U'IB fEVE�U218W.4 OP VlQ 5I8I0 Of N2pt89k8 Rl Ul@ d8IEt1111�Yd60D Of �18 amount shown to be due, and the tax�ysr h� failed to pay the amowt due after demand. If this NoBce of State Tax Lien is an extensPon of an eflective lien, it serves to continue the priority of fhe state's fnterest in fhe affected property of fhe taxpeyer. �_�,Q, �1'/Y� RevenueAgent 8.//.ap�� (402)471-5731 sign Prepar ign re Title Date Telephor►eN mber hete ► Revenue Supervisor �/ � Authorized Si9na re Title Date 4-699-7974 Rev. 2�2002 Supetsedes 44941974 Rev.1G1985 i � m \ i �0�106049