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�4 NE 51.� e� <br /> ���;—� 11«IIll111�j11�111r�l1 °� 1 <br /> . . �,a�� ,F$$v lll1�11J�I�ll1�l� <br /> ,�wp, pf„y;z0oo Oz Sa PM � <br /> ��������� <br /> � Notice of State 1'ax Lie�n <br /> �.a�.,� <br /> e.P.n.n•nt <br /> et nr�M++ � <br /> pLEas��o rao'�WRITE IN THIS SPACE <br /> Retu�n W: <br /> STA�E OF N�BRASKA <br /> O�PARTMENT OF REVENUE <br /> ;811 WEST 2Nb ST STE 460 <br /> GRAND tSLAND NE 686D3 ��,.. .:_....,_., .. _,�`y <br /> T�RMI�l�xxG���t�F 53'AT� TAX LZ�N <br /> `���".'"�'ND�YIDUAL �NCt3ME 7AX <br /> YF Y�7� I}VL�UIRc AS[31i7 Y.1'iUR <br /> �1CCOU�17i R�FER Tfl �N�S�E N�1�9BEt�5: <br /> �OC. S�C. �10. �Ob2��5b1 <br /> N��R• IDwN7+ Nd+ 4q1�5434 <br /> SP�IlS� SOC• S�C. 1��3. . <br /> TAXA6L� YEA� �.9�i5 .i�5U5 V NAYA <br /> L��.N �iD. �9155(3037 412 � 13�F# <br /> LI�N R�L�AS�c NC. C��7119927 �RAND ISLAND N� a8801 <br /> ��tJ�ITY H�1 LL <br /> DAT� �� N�XI�� Ol/,.11��'0� <br /> INS;RU�IE�1T N�7• � � L.r:L� .l <br /> PURSUai�� Tfl 7Hr REVcNU��.A�i��O�THE STAT� �GF N��3k�4SkA� MOTICE �S <br /> NcR�BY GIVC� BY �H� NE�RASKA D�F,��tT���l7 �IF R�eV�NU� THAT TH� <br /> S�i�7E TAX LI�N �1H�CGH HA5 S��N DiJ�Y �I��i7 AdaAINS= 7H� A80VE lJAM�� <br /> TAKPAY�R FOr� ZNDIVIDUAL ZNC��E T►AX�S IS �ERMINA'�ER. <br /> I H�REHY C�RTIFY "tH,�'� 7'H�E N��RA�KA D£PAR*M��IT �� �t�V"�NuE 3iAS tOMPLI�D <br /> WITH TH� R�V�NU� �.Ai�S uF TH� Sx�47E �F NE�RASiGA IN 3H� �E'it�cMINATI�N C� <br /> THIS T��t�9INATION. <br /> ���`��i'i�iii"i����� "�"�'*'fii�'7�'i• r. ��i���� �• •''*-*-.��` �+a•�*��� <br /> �"3�EPAIi�R�S SIGNATURE TTTi.= l}ATE <br /> � ��� � / 9�00�0 <br /> ... � .. 1�G��.��� • •��f� . �. .•�....... <br /> ��'�.. ' <br /> AUT�� � A7URE TI��E �7ATE <br /> NFPIRASKA DEPARTMENT OF REVEFJIi�—Whi;e and Canary Copies TAXPAYER�Pink Copy COUNTY—Goldenrod Copy <br /> PrlrnadS�S:dtonrecycredAaAor NUISII�IQ �'�'fl WdS�:tiG �i�. �z hJt�r9a�.s-�i <br />