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Tax Tax <br />CNa <br />Tix ►�,rioa <br />Itsewntwtt <br />/Ut m t of Tax <br />Panaity <br />ham. <br />Additions <br />Balance of <br />• ��...•,r wrnry mas WHO r"PrasKa uepartment of Revenue has compiled 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 Notici of State Tax <br />Lien b ension of an effective Ilan it serves to contlnue the priority of the state's Interest In the affected property of the taxpayer. <br />Taxaavers Service SDecialist Ad <br />here Pr s5igil�t Title Data <br />-�- Revenue Agent Supervisor., -�'r� <br />AuthorInI SlgnatWe Title Date <br />FOR COUNTY OFFICIAL'S USE <br />Ito iIOTYCE(s) OF "X LIMN (OR - ON) . IS (ARE) TO BE FIM OM WIM <br />--*- -- <br />THE: DOCUMM(S) Is (ARE) NOT TO.BE FORWARDED TO THE COUNTY CLERK. <br />DISTRIBUTION OF COPIlms — <br />ifHI�TEs TO BE VALIDATED BY THE REGISTER OF DEEDS AND RETURNED TO THE <br />DLPAWIWENT OF REVENUE. <br />GOLOENRODs TO BE KEPT BY THE REGISTER OF DEEDS. <br />BIZZING 18 To BE ONCE PER MONTH AND THERE WILL BE NO PRE — PAYMENT OF FEES. <br />THANK YOU FOR YOUR COOPERATION. <br />NEBRASKA DEPARTMENT OF REVENUE — White and Goldenrod Copies TAXPAYER -- Pink Copy C&JNTY OFFICE — Canary Copy <br />4 -494-74 Rey, 9.88 <br />SupersedeS 4. 494.74 Rev. 7.81 <br />L <br />J <br />m <br />2 <br />I <br />