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<br /> l .��.,: , "�'° PLEASE 60 I1CT CURiTE 1N 7HlS SPACE ; ; �.:'
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<br /> ' �D" IVIOUAL ZNCOP4E �AX ` �' � ' -' �-
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<br /> t � f . SOCQ S�to Nl�o s12g��7S ' �'�:;r �` ..`' �
<br /> • ' t�r ' NEHRa IDENTo NO• 394�i1OT0 �: `�j,'"
<br /> ''� •• SPOUSE SDC. SEC._ NO. . . ' � ..� >rl�r.-:
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<br /> , � 't;�. C�tll�P l�tlL JAICAE PEREZ ;`F�`,,:�
<br /> DATE G� N04arGE 03/4��5�8 ?l6 S PINE '� ,, • :�'�•;' '!. �.
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<br /> � ; BATF� G.� ASS�SS���JT G�����y� GRAND ISLANB NE 688�a — --- ---
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<br />. _; THIS NOTICE OF STP�'�� 7A� 4IEN IS aSSUED BY THE NE8RA54CA DEPARYP9ENT OP ,:•;���._
<br /> � � REYENUE FOR IIdDYVIDt�AI. EkI�OME TAX PiIF�SUANY 70 TNE REdENiJE LAWS 0� YHE . ."� "-"
<br /> �� STATE OF NEBRASKAs l�OTICQ IS MEREBY GIVEN TNAY INDIVIDUAL INtOME .� 'Y r�'.,�
<br /> � TAXES INLLUDING PEt�ALTIBS'AND INTERESTt �HICH ARE SHOiAN BELOM ARE DUE �� '���
<br /> � FROtd FHE TAXPAYER SPECIFIFD ABOVE AND REMAIM UNPAId AFTER DEMAND• ` '°�'
<br /> . <� THESE TAXES CGNSYISUYE A kEEN IN Y01E C�UNTY FOR PROPERTY BBL�NGIN& TO . . `"''�"�".
<br /> '' YHE YAXPAYER OR HE�EAFtBR ACQUIREOe ' �� - -
<br /> }� AI�fDU(dT Of TAX m o o m a • • • • • • • • • • • o • 292°00 .
<br />: . � . .1 PENALN . a . o a a a . e o . . . . . . . . . . . T3.00 . . _ .
<br /> � . -.� ZNTEREST (C0�4PUTED Tq 03/07/9T) • o . o . . e e • 92039 . .
<br /> , � . .,� TOTAL AMOUNT DUE o � . . . • . . . • • • • • • • 45Y.39 ,.
<br /> I HERESY CERTIFV THA'd TME NEBRASKA DEPARTGIENT OF REVENUE HAS COMPLIED
<br /> � aITH THE RE!lENUE LAbdS GF SHE STAYE OF NEBI�ASKA IN T�IE DETERMYNATIGN OF � ,
<br /> �. ��' THE AN9GUNT SHOMN TO $E D1��9 ItND THE TAXPAYER HAS FAEl.ED TO PAY THE _ �
<br /> A1�77QUidT D1J� A�7EE3 DE1+�fAND�+ IF TPlIS NOTICE �� STATE TG� LI�N IS AN -�� � �•.
<br /> '. j EX7ENSION �F AN EFFECT�V�C LIEN IT SERVES YO CONTINU� TNE PRIORI7Y GF •
<br /> i THE STATE�S INTEREST II� Ti4 A�PECTED PttOpERTY OF THE TAXPA�P�tR.
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<br /> ..�� � • �aL'�/.l.�af�l.l..� �..oeo .00/�7�.3YS�07� � .
<br /> .� �� �� •'��••o �� DA4EATELEPHONE � .
<br /> . P R S SEGNAT aE E - �? �-
<br /> � � o • •�oo 0 00000 oe i6ii��if'i��`too• e• •�e�6��"om�s�"������•
<br /> `� AUTHORIZED GNATURE TITLE DATE
<br /> NEBRASWIOEPARTMENT OF REVENUE—Nfiite and Canary CoDtes TN(PAYER—Pink Copy COUN7Y—Gotdenrod Copy �
<br />�- .'. . . �i+!��Y�aYdbOaPa� 7.t4S7IiR6v.tP96S�W�7.1dS7BRav 69t
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