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; r City state YlD Coco Stato This Notice of State Tax Lien is i=O by the Nebraska Department of Revenue for unpid taxes pursuant to tC* rtt vnee Was 44 the state of Nebraska, Notice is hereby Siven that taxes including penalties and intetccR, which are shown below, are due from the taitpatves specified above and remain unpaid after demand..These tames constitute a lien in the county for real and perstg d property belonging to the taxpayer or hemafterarquired. Tint Teat /cried Notice of State Tax Lien /MUraska 9ttYarisf Addit m tle�attnlent Or /CYCpUC ORaad instructions on reverse tide Lien Smile Number Lien I Was Date S"kal Sr.Utlty Number _ 7 -31 -86 fj Original 14.12 173.21 Qit43.93 9/05_/1_43 U pene ral 5 -10 -89 506 -24 -1381 Nebtaska 1.0. No. County 411 Lion Filed %Vitts SauuteYSowat Security V 102535 4336534 Nall l 1I caster of Dads =r54 -42119 2 -0 -87 t ru k] County G1srk BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS -- Business Name 255.54.----- 7.90 Name 39,_60 Jack A Shirley Street Address Street or Other %telling Address City state YlD Coco Stato This Notice of State Tax Lien is i=O by the Nebraska Department of Revenue for unpid taxes pursuant to tC* rtt vnee Was 44 the state of Nebraska, Notice is hereby Siven that taxes including penalties and intetccR, which are shown below, are due from the taitpatves specified above and remain unpaid after demand..These tames constitute a lien in the county for real and perstg d property belonging to the taxpayer or hemafterarquired. Tint Teat /cried Dam of Atwsarttattt Antoine of Tax Penalty 9ttYarisf Addit m Aussmant Due 7--01-86 thru 01 7 -31 -86 11 -5 -86' 56.60 14.12 173.21 Qit43.93 8 -01 -86 thru 411 8 -31 -86 11 -5-86 404.62 12.51 148.52 5 2 -0 -87 t ru 001 2 -28- 7 4 -6-87 255.54.----- 7.90 76.16 39,_60 3-0 -87 thru 01 -31 -8? 10 -a ^87 97.Q0 - - -- -- -_� S�tJ -- .:__. rc' _- 7_..7-6 - -- -01-87 thru 01 30-87 7 -7 -87 93 47 5 Q 25 7 1 - 1 -86 thru 01 0 -86 6-5-06 0 TOTAL [ $ 1:814_08 ' • yhereby certify that tho Nebraska Department of Revenue nos [6•C,S .ed With trio revenue taws o f t he State of Nebraska In ine, deter• rMl etlon of th ell sho to De due. and t*lo taxpayer nos failed to pay the amount due after darnand. It this Notice of State Tax Lien G an a not an eft five Iles 1 eves to conunue the prlorlty of the pate's Interest In the affected property of the taxpayer. * ; Taxpayers Service Specialist It sl uro Title Oats J Revenue Agent Supervisor 1; 49 Authorized Signature •-tie Date FOR COUNTY OFFICIAL'S USE NFIWASKA DEFARTME1 T OF AEVEI!1GiE — White antl GaIdenrod Ccples 'TAXPAYER — Pink Copy COUNTY OFFICE — CAfltlfy Ouoy T•ho. sttachod Notice -0 State Tax Lien .vs to he filed with both the Register of Deeds arc the County Clerk. The Register of needs is reque tnd to fon-tard this document to the Countv Clerk. White Copy - To he validated by the Register of Deeds and Countv Clerk, and returned to the Nebraska Department of Revenue. Canarl Copy - To be kept by the Register of deeds. Golder n odd - To he kept by the founty Clerk. Thank you for your cooneratinn. A 7 ar. J