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<br /> �r Notice of State Tax Lien ��n���.�_
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<br /> PLEASE DO NOT WRITH IN TNIS 8PACE ==--
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<br /> INDIVIDUAL INCOME TAX j:�-:
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<br /> � SOC. SEC. N0. 505?4570�1
<br /> NEBR. IOENT. N0. ��'
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<br /> � TAXA�LE YEAR 1996 �=
<br /> . . � LIEN N0. 972200230 ����,�._.
<br /> ' COUNTY HALL KEBBON 6 SHAMNA HEMMER s;�`
<br /> OATE OF NOTICE OA/OA/9T 3543 FARMSTEAD RD � ---
<br /> DATE OF ASSESSMENT 05/23/9T GRAND ISl.AND NE 68801 _ _
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<br />� �� � TNIS NOTICE OF S7ATE TAX LIEN IS ISSUEO BY THF NEBP.wSKA DEPARTMENT OF
<br />� REVENUE FOR INDIVxDUAL INCGME TAX PURSUANT T� THE REVENUE LAMS OF THE
<br />�ti .:.�;:;:��:1;� STAT� OF NEBRASKA. NGTICE IS HEREBY GIVEN THAT ZNDIVIDUAL ZNC�ME
<br />`��;,;;�..;:�''-, TAXES INCLUDING PENALTIES AND INT@REST� WHICH ARE SHOMN BE�OIi ARE DUE
<br />_ . , , FROM THE TAXPAYHR SPECIFIEO ABOYE AND REMAIN UNPAID AFTER DEMAND•
<br /> . - THESE TAXES CONSTITUTE A LTEN IN THE COUNTY F�R PROPERTY BELONGTNG TO ---
<br /> THE TwXpAY£R OR HEREAFTER ACQUIRED.
<br />;;;:��, �'�� AMOUNT OF TAX • � • • • • � • • � • � • • � • • • 250�00
<br /> - . PENALTY � • • • � • • • � • � • • • � • � • • � • 12�50 -----
<br />�.� INTEREST (COMPUTED TO 08/08/9T) • • • • • • • . • 7•09 --
<br />_ - - � TOTAL AMOUNT DUE . . . . • . . + . . . . . . . . 2b9.59 —
<br /> I HEREBY CERTZFY �'HAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED
<br />_ �:;:,; MI7'H THE REYENUE LANS OF THE STATE OF NEBRASKA IN THE DETERMINATIQH OF � _
<br /> • THE AMOUNT SHOMN TO BE DUEs AND THE TAXPAYER HAS FAILED TO PAY YHE -----
<br /> AMOUNT OUE AFTER DEMAND. IF THZS NOTICE OF STATE TAX LIEN IS AN
<br /> �XTENSION �F AN EFFECTIVE LIEN IT SERVES TO CONTINUE 7HE PRIORITY OF i ��
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<br /> THE STATE�S INTEREST IN THE AFFECTED PROPERTY OF THE TAXPAYER. �;�„��.,.,,.___��_
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<br /> . PR�PARER�S GNATUitE TZTLE DATE/'f LEPH�NE �.��� ;:x=
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<br /> AUT�ED SgGNATURE TITLE DATE � � ���
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<br /> NEBRA8KA DEPARTMENT OF REVENUE—White end Canary Copies TAXPAYER—Pink Copy COUNT'—Siolden►od Copy �
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