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r- 7 <br /> - ' I76- 0014 <br /> depart eat once of State Tax Lien <br /> of:revenue <br /> Home of Taxpayer Glen:A. 6/or Bernice Hadenfeldt. <br /> • <br /> (Each in his own right and as husband and wife) <br /> ' Number and Street <br /> 1050 Robertson Street <br /> City State Zip Code <br /> j;' Pt. Collins CO 80522 <br /> Doing Husiness As Lien Serial Number County Flleo: Date <br /> 6/03/224 Hall 3/15/76 <br /> Number aria Street Social Security Number I NebraSxa Identification No. <br /> 505-36-3105 <br /> City Stare Zio Code Llen f Lien Flied At <br /> E' rr--11 <br /> Diiginal �j Renewal II 12'I :..1 <br /> Register of Deeds Cu.Clerk <br /> Pursuant to the revenue laws-at the State ttl Nebraska,notice is hereby given that taxes(includingpenalties,interest.and <br /> ' additions)have been assessed and are due from the above taxpayer and remain unpaid after demand.These taxes constitute <br /> a lien upon property to the county trelunging to the taxpayer m hereafter acquired.Liens for sales and use taxes only <br /> attach to the real property of the taxpayer located within the county or hereafter acquired. <br /> INSTRUCTIONS FOR TAX CATEGORY NUMBER AND DATE DESIGNATIONS APPEAR ON THE BACK OF FORM. <br /> Tax <br /> Category Tax Penrod Date Due Amount of Tax Penalty Interest Additions <br /> Number Tax Cal For <br /> Category <br /> 1-1-70 thru <br /> 22 12-31-70 14-15-711 735.12 220.55 216.53 1,172.19 <br /> 1-1-/i thru I <br /> 22 112-31-71 4-17-721 794.00 188.00 185.95 j 1,167.95 <br /> 1-1-72 thru <br /> 22 i 12-31-72 i4-16-731 780.90 195.23 136.26 1,112.39 <br /> I 1-1-73 thru <br /> 22 112-31-73 4-15-741 925.83 231.46 106.29 I i 1,263.58 <br /> 1-1-74 thru I <br /> 22 12-31-74 4-15-751 926.12 231.53 50.88 j 1,208.53 <br /> i I <br /> TOTAL ! 5,924.64 <br /> FOR USE OF RECORDING OFFICE <br /> i1 hereby certify that the Nebraska Department of Revenue has fully complied with • <br /> the revenue laws III tate State of Nebraska in the determination of the amount <br /> shown to be due,and the taxpayer hasfailed to pay the amount due after demand. <br /> •..":11 this,Notice of Stare Tax Lien is an extension of an effective lien it serves m <br /> continue the priority ii(the state's interest in the affected property of the taxpayer. <br /> Doted this 15th day of March ,to 76 <br /> wi <br /> sign` - t ./i ; 7 . ., /I <br /> here Autnodaeo Ignat re <br /> Ti .Rev us Enforcement Officer <br /> Title <br /> av' <br /> c-493-7a Rev.1.7S r <br /> STATE TAX COMMISSIONER—with.,and Canary Ceoles Tt\HPA VER—.n111u Cony COUNT',OFFICE—Goldenrot'Copy <br /> L. <br /> 't ::!•'' <br /> • <br /> 7, L_ L <br />