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10/04/2011 TUE 15:10 FAx 402 471 4429 UCC SECRETARY OF STATE -�-�y Hall <br />� �� <br />�,01107401 <br />...�.� <br />�J002/003 <br />. _..._.._ ._. <br />.. ._._ __.�,ra�m,���:�� ---..... . <br />�E�''E��E NOTICE OF STATE TAX LIEN <br />,�,,�,.r.�.�,�..�....��� <br />This Notiae of State Tax Lien is i�sued by the Nebraska Department of <br />Revenue for unpald taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice is hereby given that taxes including penaltfes and <br />interest, whlch are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These taxes constitute a Ilen <br />in the county for �eal and personal property belonging to th� taxpayer <br />or hereafter acauired. <br />9677003 <br />/� /�� y/ l I QRegister of Deeds ❑co���► ae►� <br />Category <br />Number <br />01 <br />21 <br />20-3658058 <br />XXX XX-0859 <br />09/22J2011 I QX Original �]Continuation �Corrected I Hall <br />BUSIPIESS NAME /WD LOCATION ADDRESS TAXPAYER NAME ANO MA ILINO ADDRE <br />Tax Period Date of <br />Assessment <br />01/01/2010 ��30/2011 <br />03/31/2010 <br />01/01/2010 04/30/2011 <br />03/31/2010 <br />Amount of Tax <br />2,5Q0.00 <br />51.85 <br />Nickie J. Kallos Jr. <br />t o� Other Mailing Address <br />1704 E. 7th St. <br />Grand island <br />Penalty lrtterest <br />500.00 I 197.55 <br />2.59 I 3.64 <br />State Zip Code � <br />Ne. 68801 ' <br />Additions <br />Balance of <br />Assessment Due <br />3,197.55 <br />58.08 <br />TOTAL { $ 3,255.63 <br />1 hereby certity that the Nebraska Department of Revenue has compuea► wun tne revenue iaws or me ��a�e or neorasrca m u��s an�n��nn��u��� �� u�C <br />amount shown to be due, and the taxpayer has fafled to pay the amount due after demand. If this Notice of 5tate Tax Uen is an e�ctension of an <br />effective lien, it serv crontinue the priori of the state's interest in the affected property of the taxpayer. <br />� ' � � �� Revenue Agent a8 � ` 402 471-6067 <br />sign rep rs Signature 7itle Date Telep one Number <br />here Q Senior Revenue Agent -�� /� <br />or¢ed Si na re Trtle Da <br />9 <br />4494-1974 Rev. 2-2�2 Supersedea 4r1941ff/4 Rev.10-1895 <br />L <br />� � <br />� <br />