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<br /> � �mtice of State T�x Lien .
<br /> � nebr-.ska ;
<br /> �panmenc
<br /> of rewenue •Read fnstructions on rewrsaside
<br /> Llen Serial NumGei L�en Type OaT� Socfal Security NumDer � ,
<br /> (�Orlgindl � . . .
<br /> - 0 03 615 ❑ Rene.vat 2-15-90 �o�-��-5�2� 90.-=10122�
<br /> Nebraska I.D.Na.-- County Lien�ile6 44itb Spouse3 Soc!at 5ecurity
<br /> � �'{��i � Register ot Daeds NumDer ,
<br /> GOUnty Clerk
<br /> BtJSINESS NAME AND LOCATI�M ADISRESS TA�'z.°C'!ER NAFtE QND MAILING AODRESS
<br /> ` �3usiness Name r 0;� �
<br /> „ _ . � , . .. .
<br /> , , . � � f,i. t, r c . . .
<br /> � s:reet AC�rv�s ' , Stresc_'72nev'.'�3; :ca a���:� � � .
<br /> . , � •- . . � � . r�f r7P, {. �:�+�'t �r .. , .
<br /> ' ��L!�'ig � . . State .. � Zlp Cnde Giy . � S:a[e Zip CaCe
<br /> , . , � . � NE 68801
<br /> This Noti^.�Qz State Tax Lien is issued by the Nebraska DepartmenE af Revenue for unpaid taxes pursuant to the
<br /> revenue laws of the state of Nebraska.11�otics is hereby given that taxes including penalties and interest.which are
<br /> shown betuw,are due irom the taxpayer specifled abave and remain unpaid aftrr deinand.These taxes ranstitute
<br /> - a lien in the county for real and persnna)property 6clonging to the taxpayer or hereafteracyuired.
<br /> Tax Oate of B�I�nu ot
<br /> Catpary Tax Period pssessment Amount of Tax Penalty Incerest Additions Assnumnt Ous
<br /> Number
<br /> - -86 thru
<br /> � 21 2-31-86 2-15-90 Oo00 O.QO 10 90 _ �Q.g6 _
<br /> ;
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<br /> ' �T'OTAL S
<br /> -- 1 hereby cottlty th0t the NBbraska Ce>;:^.^.ient ot Rovenuo nas complietl with the revenuo laws�f�h0 Statn of Nobr�ska in tha qutvr-
<br /> � mination ot th amaunt,b���wn to bo Cm� <-•9 tn texpayor na5 tallQd to pay ih0 amqunt du0 0ito^=:�i1011tl. I}th15 NotIG90f StetC Yax
<br /> '. • : Uen•Is an e ;ton of an�ctivo I t. •�;�s t contlnue tho priority of tbo stdto's Interast in C".e a'fectCtl prnpgrty of tho taxpayer. f
<br /> �
<br /> �' � . � ,
<br /> . ��gn:'� �f �-� '�"` Taxpa��rs Scrvice S�2cia1 ist '-7�-��' �
<br /> #!';,.`.
<br /> er's Signaturo 7itto Uate
<br /> , '�her , . :�::.
<br /> ? ► r � Revenue Aqent Suner��=sor k�
<br /> �AUthorized Signaturo TIllo Qate �'�;
<br /> � FOR COUNTY OFfiCIAL'S USE �
<br /> THE 11TT�t�1�Q 110'T2CE(S) OF TAX LIEN (OR TERMINATION) IS (ARED TO BE FILED 0ltLY 1tI17!
<br /> � �laR OT DEEDS. •..; s
<br /> THE DOCUMENT(S) IS (111tE) NOT TO BE FORWARDED TO THE COUNTY CI,ERK.
<br /> ` bISTRI8UTI0N OF COPIES:
<br /> WHITE: TO BE VALIDATED BY THE REGISTER OF D�EDS AND FiETURP7ED TO TH�
<br />� DEPARTMENT OF REVENUE.
<br /> GOLDENROD: Td HE KE�T $Y THE REGISTER OF bEEt7S.
<br /> HILLING IS 7Yl SE ONCE pER MONTH AND Z'}IERE WILL SE NO PRE—PAYt�F,'NT OF F�E5.
<br /> THANK YOU E'OR YOUR COOPi,P�l1'ION.
<br /> ` 'r r _._—_-.
<br />. ':htlHASKA UtYAM IMtN'f�"REVtNU6�Whrt9�'::�oldonrOd Copios TAXPAYER- Pmk Copy COUNTY O�FICE-Canary Copy
<br /> 4 474•%4 Rov.�?3
<br /> 5��pe�scer.s 4•494•74 Ctov.T-g;
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