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a mot„ d v <br />�.^. •,C' "';T,.�S'v'U ,:;; h5i�� `�"'1� a^rzfr�``*.9rt5f �'tn� ,+s,�"�Kt'- � :xiF � <br />-�*'. _ : r + - t- ..t,'t�tgd.,r=1-rL ¢2h`�� �. xS- wp�ti� I •'* f... �`9'F�'i'3+C"'{�'Ij'': ihh�4.TL,• ,y*L.�y�'4h 1,w. <br />e <br />Notice of State Tax ,Lien <br />rtee`xaska <br />depu'tment a Read instructiaw an 1'eYerfe tide <br />Lion Sasitl F'+�mber t_Ian Type Dats $dClil Security Number <br />Original 10 -31 -88 507- 48-0624 <br />8/11/437 ❑ Renewal 1 <br />NtDraska 1.0. ft �. County L1M Fi�wlth Spouse's —al Security <br />Reeed umber <br />5254051 Nal i Q Co <br />F— RUSINESS NAME AND LOCATION ADDRESS <br />Business Name <br />St'r Ht AddreSS -- <br />City State <br />Zia Code <br />89— .10203 <br />TAXPAYER NAME AND MAILING <br />Name <br />Efton Riddle <br />$tree[ Or Other Malting Atdteff <br />P.O. Box 57 <br />City State <br />Shelton, NE <br />zip Code <br />68876 <br />This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the <br />revenue taws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are <br />shown below, are due from the taxpayer specified above and remain unpaid after demand. These taxes constitute <br />a Tien in the county for real and personal property belonging to the taxpayer or hereafter acquired. <br />Tax <br />Category <br />Number <br />nj 105 <br />91 <br />lax Period <br />-01 -84 thru <br />- 3 thru <br />04 -30 -8; <br />Date of ' <br />Assessment <br />- - <br />Amount of Tax <br />Penalty <br />Interest <br />Additions <br />Balance of <br />Assessment Due <br />1318.00 <br />1075.00 <br />566.75 <br />2.600.48 <br />2 959.75 <br />� <br />I <br />I <br />TOTAL I 5 5,560.23 <br />I hereby Certify that the Nebraska Department of Revenue has Coen Piled with the revenue laws of the State of Nebraska In the deter- <br />mination of the amount Shown to be due, and the taxpayer has failed to pay the amount due after demand. If this Notice of State Tax <br />Lien Is an extension of an effective lien it serves to continue the priority Of the State's Interest In the affected property Of the taxpayer. <br />sign Revenue Agent <br />r <br />Title a a. ���� T Oarer' $i ature L(12 <br />,- <br />Revenue Agent Supervisor f <br />Title Date <br />y� thor zed SignatU <br />1—' FOR COUNTY OFFICIAL S USE <br />G <br />t. <br />COUNTY OFFICE — Canary Copy <br />NEBRASKA DEPARTMENT OF REVENUE .-White and Goldenrod Copies TAXPAYER — Pink Copy ^ '^ <br />THE ATTACHED NOTICF.(S) OF TAX LIEN (OR TERMINITION) IS (ARE) TO BE FILED ONLY WITH <br />THE REGISTER OF DEEDS. * <br />THE DOCUMENT(S) IS (ARE) NOT TO BE FORWARDED TO THE COUNTY CLERK. <br />DISTRIBUTION OF COPIES: <br />WHITE: TO BE VALIDATED BY'THE REGISTER OF DEEDS AND RETURNED TO THE <br />DEPARTMENT OF REVENUE. <br />GOLDENROD: TO BE KEPT BY THE REGISTER OF DEEDS. <br />BILKING IS TO BE ONCE PER MONTH AND THERE WILL BE NO PRE— PAYMENT OF FEES. <br />THANK YOU FOR YOUR COOPERATION. <br />JIII <br />