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<br /> ^ nebr�ska �:�#f�e ��-�ia�e ��� Q..i�t� 90� UZ���S
<br /> �department
<br /> fot revenue •Read instruaions on revorsa sida
<br /> r Lim�SerirJ Numper L,�en iyF� I�ric � 5o:ra1 Secur�ty lVUmbc�
<br /> �0.,3..s, .loi�22
<br /> � 0 03 615 L• Renc.roai �2-15-90 5Q��7Cs•5�2i. 9�.r
<br /> Nebraska�•G.Pfa. County :..ie��Fi�Qa Yfun 5;.a;ty�.'G�bola�recur;ty
<br /> . , � �(1 RC9ist¢r ot p86CS,ItA•„4f�:
<br /> . Hal l J co��ts c:�t�
<br /> ' BUStNESS NAME AND LOG�'+TIqEI AAOH��s TAXPAYEfl NA1ti1E AND MAILING ADDRESS
<br /> eusiness raame raame
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<br /> , Street ACCress y5°r�!ar Other�J:ai:i?g��cre-5
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<br /> City State 21p C�cn G.y Stato 2ip C�_.
<br /> I r���,� .L r..,,.: i�E 688c�E
<br /> �i�:i I�otice of State Tar Lien is�s.��3�r tL-4 i�:4�raska Qepatunen2�u C�'.��venue far unpaid ta.ies�ursuant to the
<br /> ' cevenue laws of t6e state of hebr..�.r�'�r,tt�;.:s_;'�e.eby pven that taxes including penalties and i�:c�yst,which are
<br /> '' shawn belaw.aze due from the�i.�;�er s;,z~�:ed aboce a_�cemain unpaid after de,:.a�d.These:.�tes eonsti+tute .
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<br /> g� �. a Ucnin the county for real and F��s::o�!prope.�y�elong::-_�:�i��'.:e ta�cpayer or her�G�.i.�cquired.
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<br /> Cat�ory. •'TaX.lerec� dz�Df � Amountc:�sax i Penalty � Sr.-�� . Addi;�orts �'y''''"""f �
<br /> ' �� umber '. A��irer:t ; � li��a,:-�:+a
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<br /> --�--� 110_96 _ _ ` �'"
<br /> . TUTAL S i. ."
<br /> �norony corLly tnat�he Nonra.v..� Oov�itmcnt oi acinn.�r. n,�s��,m�,i�cu w.tn t1�C fCVitnuC IJWS Ot t�C StatC Ot NebrasY,a!n thB dCtC�•
<br /> m�natlan of thq amnunt StK�v�n to ne due,anU tr�ta�cpayrr ne:,taiied In pay tn^amount due altet dCmand It thi5 Notlee of S1Lte T.�x
<br /> � Li00 IS 0n e �S�oO n1 dn ut chva t 0�rt Sc�v�::t C�n!uiuC [hC U�ivtlty ��f UiC stat0'f u'�tC�USt �n tnc oitectcu vroparty ot tr�o taxv�vcr.
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<br /> �s�gn'� �:. � .«-� G ZL _____ TaxqaYers Service Specialist `�6`yU ,
<br /> , '�a� e�'s� at�u° "� T�uo 2e .
<br /> ° -✓' --y�---� �evenue �Gent Supervisor —� �'�� �'
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<br /> � Authnried Sig a re Trt�a CUate �
<br /> ���� � ��� � � ��� FORCOUNTVOFFICiAL�SUSE �^�� ___� `_ ,_� '� f
<br /> THL liTTAGFJEA NQ'�ICE(S) OF TNC L�.s'�J (OR �,.�3ZNATI^a�� IS (ARE) TO BE FILED ONLY i�tITf�
<br /> Tlt� 1t�C2d'1'�� OL�' IDEEDS. r`^""�
<br /> TI�IE DOCUMENT(Sj IS (1�RE} NOT TO BE FORU71#fi�ED TO THE CdUNTY CLERK.
<br /> DISTRIBUTION OF COPIES:
<br /> WHITE: TO BE VALIDATED BY THE REGISTER OF DE�DS AND I2ETURNED TO THE
<br /> DEPARTMEN2 OI' REVENiIE. ,
<br /> GOLDr,,�ROD: t� fiE 1(�PZ' BY T11E REGISTER OF DEEDS.
<br /> HILL2tJG IS T� BE ONCE PER MbNTH 1124D THERE WZLL B� NO PRE—PAYMENT OF FE�S.
<br /> 7'lU1tJK YOU FUR Y�iSR CObPER11TION.
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