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III <br />Notice of State Tax Lien <br />Irpartment <br />_..__.. *Road innrutriene an rewrsn tkle <br />Lien Sfrial Number <br />Lion Titbo <br />Date <br />Social Security Number <br />Penalty <br />Interest <br />Additions <br />Qr.gmdf .. <br />/,Yi wber <br />- - 4 <br />o <br />89 <br />1024194 <br />.Gras I.D. No. <br />County <br />Lien Filed With <br />Spouse's Social Security <br />Fi Register at Dead$ <br />Number <br />Q County Clerk <br />13USINESSIiiAME SAND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />Name <br />KOAnn Brown. <br />Street Address <br />Street or other Mailing Address <br />3525 Graham Avenue - <br />-- <br />City 5ta: t <br />Zip Code <br />City State <br />Zip Code <br />Grand Island NE <br />68803 <br />This Notice of Stue Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to tile <br />revenue laws of Oir state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are <br />shown below, afr:'due from the taxpayer specified above and remain unpaid after demand. These taxes constitute <br />a lien in the coummy for real and personal property belonging to the taxpayer or hereafter acquired. <br />Tex <br />Car <br />Tegory <br />Tax Period <br />Data of <br />Assessment <br />Amount of Tax <br />Penalty <br />Interest <br />Additions <br />Balance of <br />Assessment Due <br />/,Yi wber <br />1 nor.aby cartify that the f4C1:,-JSka Department of Re.ra•.e has compiled with the revenue laws of the State of Nebraska in the deter- <br />mination of 1,l0 amount snow• ^.o bn due. and the taxpayer has failed to pay the amount duo after demand. It this Notice of State Tax <br />rPf t 0trtsion of n effectly II nit ryes to continue the priority of the state's Interest In the affected property of the taxpayer. <br />I �he■ a a �+ (� Tit .3 <br />VIC ut eri; 9d +Cyt1�:,Ure T,1: L' vJ`a <br />FOR COUNTY OFFECU:.L'S USE <br />V <br />NEBRASKA DEPARTMENT OF REVENUE — White and Goldenrod Copies TAXPAYER — Pink Copy COUNTY OFFICE Cenary Copy <br />THE ATTACHED NOTICES) OF TAX LIENS) OR TERMINATICNS(S) IS (ARE) TO BE FILED CNLY <br />k1YTF THE COUNTY CLERK. <br />TN:= COCUMENT(S) IS (ARE) NOT TO BE FAP.WARDED .TO THE REGISTER OF DEEDS. <br />DISTRIBUTION OF COPIES: <br />WHITE: TO BE VALIDATED BY THE COUNTY CLERK AND RETUPTnE'D TO THE DEPART:JE NT <br />OF REVEE r.. <br />GOLDENROD: TO BE KEPT BY THE COUNTY CLERK <br />BILLING IS TO BE ONCE PER MONTH AND TIj1EPW WILL BE NO PREPAYMENT OF FEES. <br />L� <br />C <br />;Y <br />�d <br />W� <br />f i �- <br />