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i.� 1 r, a Notice of State Tax Lion rd imant wnw NDINDDIVIDUAL INCOME TAXI g9- 100200 IF YOU INQUIRE ABOUT YOUR ACCOUNT* REFER TO THESE NLMBERS WC• SEC• We 508600968 LAWRENCE R S DONELLE D VA.LDEZ NM, IOENT• NO. 16244419 SPOUSE SOC. SEC. NO. 505709856 1028 W SUNSET AVE TAXABLE VEAR 1987 GRAND ISLAND NE 68(801 LZIN Na• 811225343 COSITV HALL DATE OF NOTICE 09/12/88 DATE OF ASSESSMENT 05/25/88 THIS NOTICE OF STATE TAX LIEN IS ISSUED BY THE NEBRASKA DEPARTMENT OF REAM E FOR INDIVIDUAL INCOME TAX PURSUANT TO THE REVENUE LAWS OF THE.... STATE OF NEBRASKA• NOTICE IS HEREBY GIVEN THAT INDIVIDUAL INCOME TAXES INCLUDING PENALTIES AND INTERESTs WHICH ARE SHOWN BELOW ARE DUE-.' FROM THE TAXPAYER SPECIFIED ABOVE AND REMAIN UNPAID AFTER DEMAND• THESE TAXES CONSTITUTE A LIEN IN THE COUNTY FOR PROPERTY BELONGING TO THE TAXPAYER OR HEREAFTER ACQUIRED* AM01M. OF TAX • . . • w . . . . • . • . • • 349.00 PENALTY • • • • . w • • a w w • . • • w . • 17.45 TKNMST ICOMPUTED TO 08/12/881 . • • • a . • • w • • • • 15.93 TOTAL AMOUNT DUE . . w , . • . . . • • . • • OF • 382.38 I HERESY CERTIFY THAT THE NEBRASKA DEPARTMENT OF fis~V RS:E HAS COMPLIED WITH THE REVENUE LAWS OF THE STATE OF NEBRASKA INY •'CH - DETERMINATION OF THE AMOUNT SMOMN TO BE DUE, AND T14E TAXPAYER HAS FAi EO TO PAY- THE AINMW DUE AFTER DEMAND• IF THIS NOTICE OF STATE TAX LIEN IS AN EXTENSION OF AN EFFECTIVE -LIEN IT SERVES TO CONTINUE THE PRIORITY OF THE STATESS INTEREST IW THE AFFECTED PROPERTY OF THE TAXPAYER. + . . •• .l•w•��••a..••• Z.••.•s. IGNATURE DATE •e• • • • well . •.w. •. . i AUTHORIZ I ATURE DATE FOR COUNTY OFFICIAL4'S USE — NE51RASKA DEPAMMENT OF REVENUE OFFICES 1 If you• havo any Questions ragardingAbIf notice. pirsa contact thin- Nebraska 04partmant of Revenue. Box 94818. Lincoln; Nebraska 88309. or any of the ragiorial bfflcaiisted below. In Nebraska you may also dial tots. fir". your long distance acam number and 400- 742 -7474 for assistance. LINCOLN - (402) 471,2671 GRAND ISLAND - 13011)-M"A726 NORTH PLATTE - (308) 5'324260 OMAHA - (402) 564.2065 NORFOLK - (4021371.9$2A SCOTTS BLUFF - ISOf) GM -1200 t �4•. rYJRM�i� 7 NEBRASKA DEPARTMENT OF REVENUE- White and Csn3ry Copies TAXPAYER -Pink Cgpy COUNTY -- Goldenrod Copy THE ATTACKED NOTICES) OF TAX LIEN (OR TEMINATION) IS (ARE) TO BE FILED ONLY WITH + THE REGISTER OF DEEDS. �40 THE DOCUMENTS) IS (ARE) HOT TO BE FORWARDED TO THE COUNTY CLERK. DISTRIBUTION OF COPIES: WHITE: TO BE VALIDATED BY THE REGISTER OF DEEDS AND RETURNED TO THE DEPARTMENT OF REVENUE. GOLDENROD: TO BE KEPT BY THE REGISTER OF DEEDS. tw BILLING IS TO BE ONCE PER MONTH AND THERE WILL BE NO PRE - PAYMENT OF FEES.t 771MIK YOU FOR YOUR COOPERATION. � t