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RFR 18 'E© 11:21AM U.'--.0 DIVISION <br />Illflll 11116I{Eif iiiiillll IIIII IIII Ili <br />8900044988 Pal; 1 <br />GROSS JOHN a <br />Filed 64/1312000 08 34 AM <br />200002974 <br />OrNotice of State Tax Lien <br />,r....dra <br />1001 �. <br />PLE"E DO NOT WRITE IN TENS SPACE <br />This !Notice of Stab Tax iieo is issued by the Nebraska Department of <br />Revenue for unpaid hies pursuant to the revenge laws of the state Of <br />Nebraska. Notice R hereby given that taxes including penalties sad <br />iakmt, wblch an shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. ')these taxes constitute a lien in <br />the couaty fbr real and personal properly beiofsging to the taxpayer or i <br />eSkd !drin{1fi0eaen ry4niaar <br />36518190 <br />uan r.er mow• -- - -- - - - -.. <br />®eeer ofDoode❑ 'CWk 502 -84 -1510 510 -62 -7103 <br />M <br />Bede) Number <br />000560039 <br />Uen Ty" <br />®final ❑0en0" <br />lM Of Lierr Count/ <br />04 -04 -2000 BALI, <br />BUSINESS NAME AND U)CATION ADDRESS <br />TAXPAYER NAME AND MAILINM ADDRESS <br />lose Name <br />Nirre <br />JOHN G & CHRIS J GROSS <br />rt Addre4o <br />saeot or Other Msifr4 Address <br />3720 WBST STATE ST A7 <br />ZP Coo � <br />tats <br />Zip Code <br />GRAND ISLAND Nit 68803 <br />R Tax perw <br />Date of Ixrl4ufat of Tax <br />ponwty kttaraat Additions <br />A"nemont Due <br />u <br />22 1996 <br />12 -08 -99 1036.00 <br />259.00 277-15 <br />1572.16 <br />22 1997 <br />12 -08 -99 1169.00 <br />292 25 207.5 <br />1668.79 <br />22 1998 <br />12 -08 -99 190.00 <br />47.5 16.6 <br />254.13 <br />Return to. <br />STATE OF NEBRASKA <br />DEPARTMENT OF REVENUE <br />1811 WEST 2ND ST STB 480 <br />GRANO ISLAND NE 88403 TOTAL $ <br />I nerepy eartlryi "t are Nebr"k& Dopaft@M of Raverwe hag wffvm � the revenue lom of me State of Not asks in"doormination <br />of the mnount etwm t0 bo duo, and the roxpayr hag failed 10 pay trio arepur4 due after demand. tt fhfs Nodal of SYata Tax Lion is an extension of <br />an lien s soaves 10 do the Dr" d tare state's lettered in the affected FQPWW of the Oxpoyor. <br />sign 1 e Date C. <br />ft f -� <br />. pink Copy COUNTY OFFICE - CAnarY COPY <br />4.49474 Net. W-94 UP 00101 4.0&74 Acv, $.es fi <br />NE DEw M- E ! REVENUE - Whtte and Gddenrod <br />Ow*wdmarAW=W <br />2. <br />