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r L fil Notice of State Tax Lien nehraska x iFVrn,eet *Read instructlons on reverse side Lien Serial Number Lien Typo i& Original Date Social Security Number Federal F.Q. No. Interest Additions 9/02/819 ❑ Re„o.va, 2 -8 -89 47- 0375250 $gar 100733 3.24 Filed With SpousS0041 's Soa, Security Nebraska I.D. D. No. 340073 County Nall Lion i0 Register of Deeds Number 22.52 81.78 21 10 -01 -88 thru 112-31-88 2 -8 -89 0.00 1 6.56 BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name Name Erin Rancho Motels Inc._ Street Address Street or Other Mailing Address _ Box 1407 City Stato Zip Code City State Zip Code TOTAL $ 114.84 Fremont NE 68025 This Notice of State Tani Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, 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 real and personal property belonging. to the taxpayer or hereafter acquired. Tax Category Number Tax Period Data of Assessment Amount of Tax , Penalty r Interest Additions Balance of Assessment true: .l 21 /� ti 10 -01 -86 t n� 12 -31 -86 3 -9 -87 0.00 T -- 22.86 3.24 200 21 07 -01 -87 thru 12 -31 -87 4 -7 -88 0.00 59.26 22.52 81.78 21 10 -01 -88 thru 112-31-88 2 -8 -89 0.00 1 6.56 .40 6.96 TOTAL $ 114.84 1 hereby certify that the Nebraska Department of Revenue has compiled with the revenue laws OC ttte. State of Nebraska in the detdr. mi&anension wco to be due, and the taxpayer has failed to pay the amount due after demand. If this Notice of State Tax Li a ctive lien ' erves to c ntrnC:* the priority of the atate's interest In the af,:eeted property of the taxpayer, sign Taxpayers Service Specialist here -, T::ie Date cl-d'-j vg'�' Revenue Agent Supervisor r,? -13- Forzegnaure , TitlA Date FOR COUNTY OFFICIAL'S USE NEBRASKA DEPARTMENT OF REVENUE — White and Goldenrod Copies TAXPAYER — Pink Copy COUNTY OFFICE — Canary Copy THE ATTACHED NOTICES) 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: r+r;24; 1 : TO BE `v'AL.LVATED BY THE REGISTER OF DEEDS AND RETURNED TO Tiv 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. ,K ik i INP cO rA r/ r I