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<br /> Notice of Stat�e Tax Lien 90` 4 7�
<br /> � �n�arask.�
<br /> C�EpBItRV'.!It
<br /> pf r@{,2n�e •RcOd IrtStluCtiOns OA rovOr5f S(d0
<br /> L�On$arfat Numbcr Licn Fypc OatC Sor,�s�Sosunty 1'dumbar �
<br /> . �Ong�n�l �
<br /> 0/fl3/516 � ROnevvat "c-15-90 507-64-9613 94-�01�2�
<br /> Nebraska�.D.No. Cuunty � L�en FiteO LYitn SOauceY Saclal Security
<br /> 5V,Z7�28 H�1 j �i Register ot peeas NumDer
<br /> �}Caunty C�erv.
<br /> BUSfNESS NANIE QND LOCATION ADDHESS TAXPAVER NAR7E AWO MAILfNG ADDRESS
<br /> 8usiness Name Na!ne
<br /> Ranald L. ;�agner �
<br /> � Street AGtlrMS 5[reat or Otner eltaUin,ACGress
<br /> 121a :lest aivis�on
<br /> City State Z�u Code City State Z�p CoQe
<br /> Grand Islar�d PaE Y 68801
<br /> ' • This Notice cf State Tar Lien is i�;re.3 by �he'���saska Q���rtment of Re�•enne fc�r u�L zd taxes pvrsuant to t[ie
<br /> cevenue��.s of the stat� of:�e;;:�;..�^ti�;�::e,a9�- ��;Pr.;.hat taxes inclu�ing pe�::�es�nd irt��est,which�e
<br /> shawn belcR•.o:e�ay���:.t�.�_e.a��s}•er sre�a���.;.mra an�¢emain ur�µ��after de.:..�.�.d. These s�a�.�s canstir,:te
<br /> a Iien in LLe cv-ur:�r�*��^:.�':a-L��s3na1 prope:�i�ni�z�r•.�t��the ta�G��:rr 4a;�ere�ft�r�.�uired.
<br /> ' 7a�t:';+ .
<br /> �Cetegory' �„ " T8x r�:,:r mate of qmaunt of Tax �aaaity � :�:sest Additions � �tance of
<br /> NumE�•. . Assessment AssessmeM Oue
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<br />� ��• 1 ncroby ecrt�fy tbat thc ��ebrask.a Ucpartnient of kevenue ��as cornpllou w�th thc�evenuu laws of tne 5tatc of Nobraska�n tno detr.r-
<br /> �' �•a+� mulBtlOn Ot thC atnOUOt ShGVin to bC Ouc,anU the taxt,ayer��as fanetl to yJy thp,�mnunt tluo altor Uorc��nd. If th�s Notito oi 5'?•e (ax
<br /> � � .�L�O�IS 0n extenS�n ot an eflFUrve hen it se�ves h,condnur,tl�r, ��ru,nty U/ �hV SIJS0�5 mtcre,t in th0effettCl prr,parLy of trE::,xpdynr.
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<br /> ;!s�g � ' �,��, '�-���__�,���'l*�� Taxpavers 5ervice Special i st ��'�`yv ' .'
<br /> �here.% / s/� �o � -�, � � T�cio oato 'is�
<br /> ;; '` _ /�r . /����.� P,evenue Ar�ent Supervisor :/r ;%c�i ' :�
<br /> .� �'?'^'F 1 --••-- ----- - 7�tic Date r:
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<br /> 1• �T__ _� ,v FOR COUNTV OFFICIAL'S USE __ �� ^_y__�
<br /> ZltE 11TT1YCNED NOTICE(S) QF T]SX LIEN (OR TERMINATION) IS (AFcE) TO BE FILED �.Y 1iITN
<br /> 'x4t�t pCIl1�1t OF DEIDS.
<br /> THE DOCUMEt3T(S) IS (ARE) NOT TO BE FOAWARUED TO '1'F�E COUNTY CLEFLK.
<br /> DISTFtIBtTTION OF COPZES:
<br /> WHITE: TO H� VALIDATED SY THE R�GISTER OF DEEDS AND RETURNED TO THE
<br /> DEPAATMENT OF REVENUE.
<br /> GDLDENHUDe TO HE KEF'T BY Tf1E REGISTER OF DEEDS.
<br /> BILLING IS TO E� CNCE P�R rlUNmtl AND TH�RE DiILL BE rI0 PRE-PAYl�N'P flF FEES.
<br /> TH1�NK YOU FpR YCU? r'!U'.1P�R11TtON.
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