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<br /> . �� ��r Notice of State Tax Lien � �� � -
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<br /> • PLEASH DO N�T NRITE iN TFNS SPACE � —
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<br /> INDIVIDUAI. INCOME TAX
<br /> S�C. SEC. Nn. 5077453T7
<br /> NEB�1R. IDE�1N�+T. N0. /1 17280982
<br /> .. . . � JfY�JG JY`• JG�^.•• I\Y• -
<br /> TAXABLE YEAR 1993
<br />_�" ` LIEN NO. 971080039
<br /> . � � C�UNTY HALL ROCKE J JURZENSKI
<br />'��;-�``•�%',«���� DATE OF NOTxCE 04/18/9T 2912 M COTT/1�E
<br /> _: �+p� DATE �� A5SESSMENT �7 GRAND xSLAND NE 68803
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<br />�=��� � THIS NOTICE OF STAT� TAX LZEN IS ISSUED BY THE NEBRASKA DEPARTMEN7 OP
<br />�''``=" -�•�:�r REYENUE FOR INDIVIDUAL INCOME TAX PURSUANT TO THE REVENUE LAMS OF THE
<br />�'"';,�'���� 3TATE aF NEBRA5KA. NOTICE IS HEREBY GIVEN THAT IND�YTDUAL INCOME
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<br /> -`-- �' TAXES INCLUDING PENALTIES AND. INTEREST� NHICH ARE SF�LONN BELON ARE AUE
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<br /> �'��^�� FRDM THE TAXIAYER SPECIPIED ABOVE AND A[EMAIN UNPAID AFTER DEMAND.
<br />��`�0E'`�� = THESE TAXES CONSTITU7E A LIEN IN THE COUN'TY FnR PROPERTY DELONGIN6 TO
<br /> r� "''�� � TH� TAXPAYER OR HEREAFTER ACQUIRED•
<br />�:�;','.,;� —
<br />`"'''�� � AMCIUNT OF tAX • • • • • • • • • • • • • • • • • • 193.00
<br />�-`"'`'""'i`• PEldALTY • • • � • w • • � • � • � • • • • • • • • 9�65 -
<br />.:� IN?�REST (COMPUTED TO 04/18/97) • • • • • • • • • 49.55
<br />`�`n' TATAL AM�UNT DUE . . . . . + . . . . . . . . . . 252.20
<br /> .� ��
<br />� I HEREBY CERTIFY TNA7 THE NEBRASKA AEPIeRTMENT UF REYENUE HAS COMPLIED
<br /> ��� � MITH THE REVENUE LAWS Op THE S7ATE �1= h1EeRASKA YN THE DETERMINAT3QN OF
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<br />-=�u••�: • THE AMQUNT SHOWN TO BE DUE� AND THE TAXPAYtR HAS FAILED TO PAY THE
<br />�r �`�'�`�- AMOUNT DUE AFTER DEMAND• IF THIS NOTICE OF STA'i E YAX LIEN IS AN
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<br />`���''`��- ��•• EXTENSION OF AN EFFECTIV� LIEN IT SERYES TO CQNTINUE THE PRIORITY OF
<br />=t - .��.�s �' THE STATE�S INYERPST IN THE APFECTED PROPERTY OF 7NE TAXPAYER+ �
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<br />- , P�tEPARER� SIGNATUR� TITLE DATE TEI.E�HONE
<br />- . ,�. �.::��..... .�:310:s .-�C J�s4`::3Y ..�.�:�........ �"
<br /> � ��1UT D SI N� ATURE TItLE ���� DAT� ' T�
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<br /> ' NEBRASKA DEPARTMENT OF REVENUE-White and Canary Coples TAXPAYER-�Pink Copy COUNN-Goldenrod Copy
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