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� - <br /> �r�b,e�a 78� u01?�2 Notice of State Tax Lien � <br /> dapartmm� . <br /> . ot revenue . . <br /> � �Name ot TaxOayer � � � <br /> Eugene W. Dominick <br /> � Numwr anC St�eet � . � � �� <br /> 19 Robin <br /> c�ty state zia coae <br /> Alda NE 68810 <br /> Doing Busineu As Liaei Serlai Number County Filed: Oate � � <br /> Dominick's Fumiture Repair 8/03/944 Hall 3/06/78 <br /> NumDar antl Street Social Securlty Number Nebraska Itlentlflcation No. � <br /> 518 N Vine 483-50-4591 01-1523309 <br /> Clty State Zip Coae Llen Lien i1�eC�At . � <br /> GTSIId ISZaIId NE 6$$�l ong�nai ❑Renewai Register of Deeds ❑co.c�ark � . <br /> Pursuartt to the revenue laws of the State of Nebraska, notice is hereby given that taxes(including penalties,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 in the county belonging to the taxpayer or 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 OATE DESIGNATIONS APPEAR ON THE BACK OF FORM. � � <br /> � T� Toal For � � <br /> . Gtpory Taz Period Dab Dus Amount of Tax P�nalry Intarast Additions Tax Cs <br /> y� Numb�r tsDorY � .. <br /> 7—01-77 thru <br /> O1 9-30-77 3-03-78 30.83 25.00 .77 56.60 <br /> 0-01-77 thru <br /> Ol 12-31-77 3-03-78 30.83 25.00 .31 56.14 <br /> � � . TOTAL 152.7�+ � <br /> � � � � � FOR USE OF RECORDING OFFICE � . <br /> I hereby certify that the Nebraska Department of Revenue has fully complied with <br />? the revenue laws oC the State of Nebraska in the detemrination of the amount <br /> shown�to be due,and the taxpayet has failed to pay the amount due after demand_ <br /> If t}ii§'Nouce of State Tax Lien is an extension of an effective lien it serves to <br /> continue the prioriry of the state's interest in the affected property of the taxpayer. <br /> Dated,;this 6th , day of P7arch ,19�$ . <br /> i <br />� aign <br />';���-� �5��'Aut rizatl gnature <br />��. : M3II88 L . <br /> Titla <br />� <br />� �.� . �� 4494-74 Rev.33-775uparsstlas4-49474 Rev.3-75 .. <br /> � STATE.TAX COMM�SSIONER—Whlte antl Canary Copief TAXPAYER—Pink CooY COVNTV OFFICE—GOltlenroO Copy , __. <br />,. �,. . ... . .. . � <br /> ..« ......,,,,_... ..... ... ' ._. .. ....._. .... .. .. � . . . ..... .. . . . � <br /> C � ... . . . . . . . . <br />�. ... . . . . .. . . . . . <br />` .. . . � . . . � . . . . <br />,.. ... � � � ` <br />