|
' i. � � � . . � . ��/ '
<br /> . ".�'� �}!
<br /> �l �1. .i. •. .. . . "
<br /> 1 ���C�'�.f • .. .. . " . .� ' ..' . .. �.���hr7��'�n�
<br /> ' �i: �I f!�`�_..��.'�� .
<br /> . �. ' �C. " � ___�::-.
<br /> .,� : � -' " ' 1:. . . �. . ��.� � •;..j�^:'r-�::�.
<br /> _ - + . . � ��� '• � .. ..��y -,` ---:TY::•kiii..
<br /> ,- . . .. .. . �` . . :,�:T�+- __ ...._
<br /> . .. . " _. . .. ` . ,. '.u:.;fii-: -
<br /> � . . . 'i � .- , . ..-.. .., _'`'—�L�;�;�
<br /> < , ,. .�......•,.•.,,a�Min,�. .{b�,'a.
<br /> . ,�: � ' ..
<br /> „ .. �� � � rn
<br /> . �
<br /> fM ; �
<br /> . ��� •'� . . � � ,
<br /> �
<br /> �`� � � � ^� •» � A.
<br /> `� +� ` �- 1 � FI, '� =n � �,., • ..
<br /> � � � �,i.� ..� � r� O p
<br /> P..«, .�.�''."� � � f°� '�' ? `�., � � :: � � ..
<br /> ' � 1` .) � ....��.'. �"� � . .
<br /> � ` � `��j �, m c# 0 �� •-��-.
<br /> `i� �� � '�
<br /> c
<br /> .. , *' I I� Y f.r�-
<br /> .t �1.d��
<br /> �°; ,�w.� ..a_ Y���L� a/►
<br /> �j ������ �� ����� �f�lA �fii� �j,dti_
<br /> eIF: -
<br /> . � �_ � `dr'-`:
<br /> � �� � ='-_.--
<br /> -�-�- .,!TfNS SPAGE �'';_
<br /> d� ' PLEA.SE DQ H�S21i MiFu"I�'� f�:�v-
<br /> �;- -;
<br /> F
<br /> . '�1�i�P1atloe ot Slate Ta:Uet k�EuYa1 b�tl�e Nebr�ul�Dep�d�t ot �-•�_
<br /> ; �: es�e tor arpa�d�+Pdrs�t�o tYe re�e�se Yws ot tie sta�� �_�
<br /> � e�t l u�t t�t,c s M c:I r d i�P� '"-
<br /> : . N���. Nalks h i e a b7 s h' e
<br /> ..� Y�wl�{c��reslw� �M.�� ,��constihtea���En �'-.
<br /> ixbw��d res�M uP� to tic tasp�lcr on• �-r
<br /> , � t�e oo�h toe rcd��ad persood p�J bda�°'a =
<br /> �!�!T • SOCM�S�a�x'/Of FWo►al I.D.Nun�tM 6paM��o 6ot1N 6w��H�+n�
<br /> _ �ICMMforiOANurtMr 1,.,'-'t.�"..�''4�
<br /> R.ya.acos.a D�� 47--p186830
<br /> 400 73 �� oato c411ea �'ti
<br /> u,ns.rwl � p a,,,y�,,,�,,, ❑carectea 3_26-97 Hall
<br /> p S�_ 1A%�AVh�t QiJ1����A�'.•INO ADDfaESd
<br /> p1a�1NE�3 NAME Ali�IOCATION ADDRE6S �
<br /> " Bu�YMM tim» ThE HeT1l�A-LC^I7Ilk'1n11 C�l�Y�---- _
<br /> � . SvMtaolhaM�iriG�'�
<br /> ��"' I�0 Box 1366
<br /> sur. ev a°a"
<br />- .. c�y �' �� � and 68802 —
<br /> ;.:,,.w:�::.t o.Ma /y�ou�taT�t P+�r�lh► k"""'t w'S°"i°"� �'°"'�""'t°"' --
<br /> ::.�.�:�s<< 1fMOCP�riod �Mnt
<br /> '_.a.::;sr,:;.:;
<br /> :xs._.-r.� 175.94
<br /> _:�'">:� 10-01-95 tYuu �,f�� 1G3.33
<br /> -,•-�,�c-- -
<br /> '� ��''4'.:` ' ' =_`._
<br /> � „; � ''. , 10-01-96 thrLi _ _0 0.00 73.31 Z�530.50 -
<br /> y'.�-
<br /> .. �y;t�_:
<br /> -- � �� 11-^1-96 thru . 1 136.36 36.E0 1 530.57
<br /> _ .. .'�4....
<br />..."_A�. ^`' . — _ � �
<br /> �`�,:,,,;►.,-_.� 12-1-96 thru 1��.g 19.50 1►469.43
<br /> .�.� I
<br /> _ ';;;� — —
<br /> ..:;.�.
<br />_ -' .f•� .
<br /> :& TOTAL s� 705�� —
<br />.., � k
<br /> � � e'��pY�y�atlh�t�Mb�kaO�D��O��"»�0°��wNAiAer��u.I�wrdtl�6traat�bra�kantM�sMirmYWion a
<br /> h�stYvdtopayY�Y�w�+tRduusllrMrtnnd.HitYHOYo�atS1�NT�xUrtl��nYtM�rfo�M �
<br /> .. ;' dEw�amourRM�ow�bb�du�.�ndrila'�YK �.� IntMdN�clodPmDMt�►d11Mt+s�ay+r� °.-
<br /> • � k bOO�MI��aM
<br /> ., � r ��} "'�!O 7� 6:
<br /> gign �, � _
<br /> �»� °.
<br /> . . ! her� ��. � =
<br /> . ,b.
<br /> --� --- - -_- • °-- -. -- •------�^-•-----'r.,nioa TAXPAYLCR-PWtCo{9Y CdUN1Y0FPICE-Ca11�YCAPY
<br /> -�.e�sa ar e.06
<br /> . -___ .._.__.___-� . .
<br /> DEPAR'TMENT OF FIEVEIYUt•Rrto a�w..�....••-----�-- s��.i�r.;ia�o ow>.-•----•--
<br /> :�.� ���e�us+�►� �-
<br /> � ....,. __..�.-—.--.-�--�- --- -�----- -.:�,t,-v-,;,p,i,�a.:�4R2
<br /> �..,..- -.- ,.
<br /> .._..... ..—_...._...,.:,:. •
<br /> -------•-`-------- �--..._.� ----....,---- _ - - -.... . .,...,,, m;i�-�� (-
<br /> �;
<br /> . �
<br /> . - •,
<br /> . � _
<br />
|