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I <br />L <br />jm�e- <br />nebraska <br />ht <br />of rever�w <br />�X . <br />Notice of State Tax Lien <br />•Read Irutruetittlta oft rweme We <br />Lianseriat Number <br />Lien Type <br />Date <br />social Security Number <br />(I Original <br />9/02/?51 <br />C Renewal <br />2- 222 -89 <br />A <br />89— V 0 O�� � <br />Nebras" I.D. No. <br />County <br />Lien Filed Wit." <br />Spouses <br />10 Register of Dead <br />Number <br />5055571 <br />1 Hall <br />I []county Cleric <br />BUSINESS NAME AND LOCATION ADORISS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Bus►ne" Name <br />Name <br />The Floret Flower Shop. Inc:: <br />Street Address <br />Street or Other Mailing Address <br />6G9 South Locust <br />City <br />sYatn ' <br />Zip Code <br />Cit.4, . State Zip Code <br />Goa. *,c€ 'Isiarid NE 68801 <br />This Notirra o F by the Nebraska Deo#(ment of Revenue for, upp4l taxes pursuant to the <br />revenue Tawd £ itkE. of Neii ,"-i Notice is hereby gnrra iitafl taxes inchrding *p and interest. which are <br />shoes iiKi ,: 2 rL fftflm the takpayer speei4ted above >t iralin unpaid after demand: These taaes constitute <br />a lice is die � iiiis4't j' rot real and personal property betoaging:�� ��laxpayer,ur hereafter acquired. <br />T1' Gate at j Caw Tax Ii RM Amount of Tax natty Interest Additions Ner -- -- -- Atasument 1 AaticementDue <br />i <br />minatiCm t;,-.jPp amount sh wn to bo Gue, and the taxpayer has •rrJnd•.;o pay the amount due afrar demand. If this Notta» of state Tax <br />Lien 34 ,j,. ' nsion of an a fective liepjit serves tol continue tttein•'j:6ty of the state's Interest inQfteaffected property Of tt►o taxpayer. <br />sign L Taxwypm. -° rvice Specialist <br />her s Sig re Title Otte <br />Revenue Agent Supervisor 112-12A-P9 <br />Authorized signature + Title Date <br />F-CIR COUNTY OFFICIAL'S USE <br />NEBRASKA DEPARTMENT OF REV ENUE — White and Goldenrod Copies TAXPAYER — Pink Copy COUNTY OFFICE — Canary Copy <br />ME ATTACHED HOTICE(S) OF TAX LIEN (OR TERMINATION) IS (ARE) TO BE FILED ONLY WITH <br />THE REGISTER OF DEEDS. <br />THE DOCUMM (S) IS (ARE) NOT TO BE FORWARDED TO THE COUNTY CLERK. <br />DISlRIBlyrIuN Off- COPIES: <br />WHITES TO BE VALIDATED BY THE REGISTER OF DEEDS ACID RETURNED TO THE <br />DEPARTMEtiT OF REVENUE. <br />GOLDEIIRODt TO BE KEPT BY THE REGISTER OF DEEDS. <br />BIIaLItiG IS TO BE ONCE PER 14011711 AND THERE WILI. BE NO FRE— PAYMENT OF FEES. <br />THANK YOU FOP. YOUR COOPERATI013. <br />�y <br />f <br />i <br />' 1 <br />r +fir <br />r = vl <br />c <br />