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. _ 1 � <br /> �' ` . <br /> i <br /> � Ido#ice of State �ax i.i�n <br /> �ehraska <br /> dap�+tment <br /> of revenu� •R�ad in�tructlonson��vsn�oid� <br /> Llon Sa1a�Numder uen ryno Date• Socl�l SKUrity NumCar <br /> � �]Or�vina� <br /> a�o��60� [_] Renewa� a2-s�-8g sos..�a-�7to �a - 1UU06 i <br /> tv�praska�o. No, co�nty u!v�'�n Fub Witn svous�v Soci��s�curuy <br /> 4162358 Hd�� c� ��9�star of�sedsNumber <br /> ❑CauntY Ctork <br /> � BUSINES9 NAME ANO LOCATION AODRESS TAXPAV�R NAME AND MAILIN�ADDRESS <br /> Butfness Name N�me <br /> K'rb Ke'm <br /> StrNt Aotlr�ss St�e�t ar Otn�r Malling Addr�ss , <br /> 102 t•Jest 25th Street <br /> City stata 2Ip Cod� Cltv state 21D Code <br /> Kearne NE 68847 <br /> This Notice of State Tax Lien is issued by the Nebnska Department of Revenue for unpaid taxes pursuant to the <br /> �evenue laws of the state of Nebraska. Notice is hereby�iven that taxes including penalties and intenst.which are <br /> shown below, ue due from tht taxpayer specified above and remain unpald after demand.Thesc taxes constitute <br /> a lten in the county for rql and personal praperty belonging to the taxpayer a hercxfter acquind, <br /> T� Dat�of Balana of <br /> Gtpay Tax'iNod A��Mi Amou�t of Tax P�naity tntK�st Additioos q��nt Du� <br /> Numb�r <br /> - t ru <br /> 21 03-31-87 6-08-87 0.�0 7.50 0.40 7,90 <br /> 04-0 -87 thru <br /> 2�i U�-�3U-87 � �-22-89 188.0a 47.00 'v3.?4 2�8.T� - - - <br /> - -8 t ru <br /> 21 09-3�-87 1-22-89 188.00 47.00 57.11 292.11 �� <br /> 10-01-87 thru � � <br /> 21 12-31-87 1-22-89 188.00 47.00 50.48 285.48 � ' ;, <br /> OI-Ol-88 thru � '�� <br /> 21 03-31-88 1-22-89 188.00 47.00 43.99 278.99 C..' �' <br /> 0�-U -S8 �hru � ' <br /> i� o�-�v-es ti-zz-a9 i��.o� 47.ciu si.sy LlL.s� .�- _ <br /> TOTAL � 1 435.57 � � <br /> . 1 hereby e�rtity th�t tho Nebrasks O�partment of Revenue has compllEd wlth Lhe revenue IawS of the State ot N�brafka In tha tlatOr- � <br /> • minstion of the amount shown to be due,and the taxpayer has failed to pay the amou�t dus after d�mand. if thif Notics of Stste Tax <br /> }', Lien is an extension ot an eftective Ilen It sarves to contlnue the prlority of the stata's InterASt In the aff�eted proWrty of the taxpayar. <br /> ? <br /> . . �g� � ..� Revenue Aqent Sypervi sor /-Z —�'G <br /> �S�e Pr�p r's Sly� u Titts D�te <br /> �•� ' r��.J� Revenue Agent Supervisor J�Z-`)� <br /> • � Authorlud Siyn�ture Tltle Date <br /> FOR COUNTY OFFICIAI'S USE <br /> :�� <br /> � ;;— <br /> 4 � , "t <br /> NEdRASKA OEPAR7MENT OF REVENUE-Y11hit�ar�i^-�' '^�j-- . :�"a"'�—D;^%���� COUNTY OPFICE-Gntry CopV <br /> +1'� RT�,'!1'!!1') 110�1'ICEIS) dF TRX LZEN (OR TERMINl�TION) IS (ARE) TO BE FILLrD �Ot�Q.IL r�aau •- , <br /> 'l� �M!'!!� tR �S. r=��_,__ <br /> THE DOCUMENT(S) IS (ARE) NOT TO BE FORWARDED TO THE COUNTY CLERK. ' <br /> b2STRIBIJTIQN OF COPIES: ' <br /> WHI1'E: TO BE VALIDATED BY THE REGISTER OF DEEDS AND RETURNED TO THE ' <br /> DEPARTMENT OF REVENUE. <br /> � GOLDENROD: TO BE KEPT BY �HE REGISTER OF DEEDS. <br /> BILLING IS TO BE ONCE PER MQNTH AND THERE WILL BE NO PRE-PAYMENT fJF FEES. <br /> � <br /> TNANK YOU FOR YOUR COOPERATION. �' <br />. . <br /> t i . <br />: � � <br />