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��neGraJ a �artnrent of ..venue Notice of State Tax Lien • Rend Instructions Oss r.vi.rea. "I. Lien Ser lal N, mber Lien Type Date SOCIal SeCurity Number 9/05/144 Q Renewal 5 -15 -89 506 -72 -9133 89--e 102,589 Nebraska I.D. No. County Lien Feed Wllh spouse's Social Sec urlty 5523990 Hal l i3 Register of Deed Number u County Clerk 5_11 -89 I 75.00 _� — F i 'JSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name 103.79 Name Michael Wieczorek Street Address Street Or Other Malang Address 662 Faidley #1 City State ZIP Code _ City State zip Code _ Grand Island, NE 68803 This Notice of State Tax Lien is issued by the Nebraska L\partment of Revenue for unpaid :axes 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 duc front the taxpayer specified above and remain unpaid after demand. These taxes constitute a lien in the caauty for real and personal property belonging to the taxpayer or hereafteracquired. Tax - FCategory lax Period N u m ber L�ate of Assessment Amount of Tax Penalty Interest Additions alliance of Assessment Dua -- '01 -01 -88 thru 21 i06-30-88 -- I 5_11 -89 I 75.00 _� — 18.75 10.04 103.79 _ TOTAL �1�3.79 ^"I"I —1-1y —11 inc Ireurasiu ueparimeni or rlevenue has Compiled with the revenue laws of the State of Nebraska In the deter. n,lnation of the .mount snu to be due, and the taxpayer has faded to pay the arnnunt due after demand. If this Notice of State Tax Lien is an r IOn Of an effe live lien arvr to continue the priority Of the state's Interest :n the affeCted property Of the taxpayer. herey Taxpayers Service Specialist ,1 hereP s- ,na \uro Title Date 0, G 1 Revenue Agent Supervisor S -129 Au['iorlr�d S�ynat ure —_ Title Date FOR COUNTY OFFICIAL'S USE G NEBRASKA pFPAHTMEfJT OF REVENUE — 6Yh,te and Goldenrod Copies TAXPAYER - Pink Copy COUNTY OFFICE — Canary Copy THE ATTACHED NOTICE(S) OF TAX LIEN (OR TERMINATION) IS (ARE) Ttf BE FILED ONLY WITII TdE REGISTER OF DEEDS. THE DOCUMENT;3) IS (ARE) NOT TO BE FORWARDED TO THE COUNTY CLERK. DISTRIBUTION OF COPIES. WHITE:: I'D £E VALIDATED BY THE REGISTER OF DELDS AND RETURNED TO THE DEPARTMENT OF REVENUE. GOI,DENROD: TO BE KEP'P BY THE REGISTL•;R OF UliF:DS. ISiLLING IS i'O BE ONCE PER MONTI; AND THERE WILL BE NO PREPAYMENT OF FEES. THANK YOU FCR YOUR COOPEIU1TION.