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F 1 nebraskuena artmt O }revene Notice of State Tax Lien 0 Read instructions an "worn $I* 89--- 140599 Lien Serial Number Lien Type Date Social Security Number Penalty Intense Additions Q Original Numtlar inue the prior6tiy of the state's titteMt In the affected property of the taxpayer. .Sign 9/02/789 [] Renewal 1 -31 -89 506 -42 -8864 03 -01 -88 thru Nebraska 1.0. No. County Lien Filed With Spouse's Social Security 3629376 halt ® Register of Oaeds Number - 4 County Clerk 04 -01 -88 thru BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name 4- 30-88 9-21-88 Name lQA8 29.27 112-73 Don L. Schmitt Street Address Street or Other Mailing Address 06 -01 -88 thru 06-30—a8 w 612 W. 3rd City State Zip dcdo City State Zip Code Grand Island, NE 68801 This Notice of State Tax Lien is issued b;; the Nebraska Department of Revenue for unpaid taxes pursuant to the revenue laws of the state of Nebraska. Notice is hemby given that taxes including penalties and interest, which are shown below., are due from the taxpayer specified sibove and remain unpaid after demand. Thest~,W-s constitute a lien in the-count� for real and personal pMpedy belonging to the, taxpayer or hereafter acquits . Tax Category Tax Pe►irxl Data of Assessment Amount of Tax Penalty Intense Additions Balance of RiiirisidGii Owe Numtlar inue the prior6tiy of the state's titteMt In the affected property of the taxpayer. .Sign S Taxnav rs t ryi_e S #prialjst_ r's5 ra 03 -01 -88 thru .here k Revenue Agent Supervisor Authorised Signature 01 03-31-88 4-29-88 - 4 04 -01 -88 thru 4- 30-88 9-21-88 72.98 lQA8 29.27 112-73 05-01-88 thru 06 -01 -88 thru 06-30—a8 w 07 -01 -88 thru ZAL 15.59 P. 01 08 -01 -88 thru 08-31-RA 9-99; 919-zfi 09 -01 -88 thru TOTAL $ V NERRASKA DEPARTMENT OF REVENUE — White and Goldenrod Copies TAXPAYER — Pink Copy COUNTY OFFICE — Cenary Copy THE ATTWHED NOTICE(S) OF TAX LIEN (OR TERMINATION) IS (ARE) TO BE FILED ONLY WITH THE REGISTER OF DEEDS. THE DOCUMENT(S) IS (ARE) NOT 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. BILLING IS TO BE ONCE PER MONTH AND THERE WILL BE NO PRE — PAYMENT OF FEES. THANK YOU FOR YOUR COOPERATION. 7 M 1 hereby Cert that the braska OepartnmeMt of Reverme has compiled with the revenue laws of the State of Nebraska in the deter- mination of t ount shown No be due nd the taxpayer has failed to pay the amount due after demand. it this Notice of State Tax Lien Is an a ilon of an effe we Ile inue the prior6tiy of the state's titteMt In the affected property of the taxpayer. .Sign S Taxnav rs t ryi_e S #prialjst_ r's5 ra Title Date .here P Revenue Agent Supervisor Authorised Signature Title r=ste F09 COUNTY OFFICIAL'S USE V NERRASKA DEPARTMENT OF REVENUE — White and Goldenrod Copies TAXPAYER — Pink Copy COUNTY OFFICE — Cenary Copy THE ATTWHED NOTICE(S) OF TAX LIEN (OR TERMINATION) IS (ARE) TO BE FILED ONLY WITH THE REGISTER OF DEEDS. THE DOCUMENT(S) IS (ARE) NOT 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. BILLING IS TO BE ONCE PER MONTH AND THERE WILL BE NO PRE — PAYMENT OF FEES. THANK YOU FOR YOUR COOPERATION. 7 M