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<br /> � �' � Notice of St�t� Ta�c Li�n �=
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<br /> - PLEABE DO NOT WRITE IN TH18 SPACE � -^
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<br /> INOIVIDUAL INCOME TAX
<br /> ' �+, '• ��+r are ��^ L9U'aL QA7C
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<br /> ` NE9R. IDENT• NO• 379T74�3
<br />";;.`�' ' SPOUSE SOC. SEC. N0•
<br />=a:`,��;;�''ti,`:;: � TAXABLF. YEAR 19�95
<br /> �aT;��'"''��r'•. LIEN NQ• 971640213
<br />` �°"`�� � CGUNTY liALl ALSERTO H�LGUIN
<br /> �""'"w�'�'�`'" DATE OF N�TICE OT/03197 2027 NEST 11TH AVE
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<br /> y�i=.=:•��`"� DA7E OF ASSESSFiENT C51:30�:7 GR�RD ISl.!!�l�D NE �AA�3 --
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<br /> � `��-''�-' THIS N�TICr OF STATE TAX I.IEN IS ISSUED IiY THE NEBRASKA DEPARTMENT OF
<br />��� REVENUE FG1i INDIVICUAI. INCGME TAX PURSUANT TO THE REYENUE LAMS OF THE
<br />-"�"""='"�'� STATE GF �d�BRASKA. NGTICE IS HEREBY 6IVEN THA7 INDIYIDUAL INCOME
<br />���'.��; TAXES INCLUDING PENALTIES AND INTERESTs WHICH ARE SHaMN BELON ARE DUE
<br />--�`:��-�,� FRGM TNE TAXPAYER SPECIFJED ABCYE AND REMAIN UNPATD AP'��R DEMAND.
<br />°�.����F''��_ TH�SE TAXES CCNSTITU?E A LIEN IN THE C�UNTY FOR PROPERTY BElON6ING T�
<br />_�.:. �s.�F�,�!
<br /> -��� � THE TARP/1YER CR HEREAPTER �CQUIIiEO.
<br />-=>:;;�;,� AMCUNT �F YA% . . . . . . . . . . . . . . . . . . 183.00
<br /> -- PENAL?Y • • • • • • • • • • • • • • • • • • • • • 15.80
<br /> ^,���� � INTEREST (COMPi�tED 7A 0?/03/97) + • • • • • • • • 32•46
<br /> r.�.���-� TCTAL AMOUMT D�E • • • • • • • • • • • • • • • • 231.26
<br />�r'�'�-'� I IiEREBY CERTIFY' THAT TME kEBRASKA DEPAtiTMENT OF REYENUE HAS C�MPLIED
<br /> �=='j��,'� WITH THE REVENUE LAkS C� THE STATE OF NEBRASKA IN THE DETERMINATION GF
<br /> ��!`,`':"- THE AMOUNT SHaMN T� 8E DUE� ANt THE TAXPAYER HAS FAILED 70 P�Y THE _
<br /> � AMGUNY DUE AFTER DEMAND• IF 7HIS N�TICE �F STATE TAX LIEN IS AN _
<br /> ;��� ' EXTENSICN OF AN EFFECTIVE LIEN I1 SERVES TO CGNTINUE THE PRI�RITY �F _
<br /> . THE STATE�S INTEREST YN YHE AFFEC�ED PROPERTY OF THE TAXPAYEii.
<br /> " � � t �97 �P�Go r� 6�.
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<br />- � � PREPAR R�S S GNpT.IRE TITLE DATE/TELEPHCNE
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<br /> � . � NEBRASKA DEPARTMENT OF HEVENUE—WhNe end Canary Cap�es TAXPAYER—Pfnk Copy COUNTY—Ciaidenrad Copy
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