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U"Seriet Number- <br />uan Type - - <br />Data . _' ....... _ <br />SioclalSecufity Number <br />< nA 7 _A A- J�__AC___ <br />IL <br />'0/08/875'*, <br />❑ Renewal <br />8 -16 -90 <br />506-66--5879. <br />Nabraws t.D. No, <br />County <br />Well Filed With' <br />spews*,-, Social Security <br />Additions <br />��p Of <br />Number <br />5336899 <br />Hall <br />p county C Gam" <br />Asatmertt Ous <br />- €Sid{i1RR1EAM LOCATION AWROM <br />TAXI►AY011MAfi1EAIM MAILlPMAWRESS <br />ausines; Name <br />Name <br />James M. Sander <br />Street Address <br />Street or Other Mailing Address <br />218 North Marrison Street <br />City <br />state <br />zip <br />code <br />city. State zip cods <br />-- - -- - <br />Grand Island NE. 68801 <br />t This Notice of Staff Tax lien is hayed by- the Nebraska Department of Revenue for unpaid taxes pursuant to the <br />f revenue laws of the state of Nebraska. Notice is hereby siren 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 />alien in the county for real and personal property belonging to the taxpayer or hereafter acquired. <br />T'lt Data+ of <br />• NCat �y Tax Period A���t Amount of Tex Penalty Interest <br />M I nation of the amount snown to be due. and the taxpayer has failed toiipay the amount duels terdemand to to s Notice of State Tax <br />Lien is an extension of an effective lien it serves to continue "- priority of the state's interest in the affected property of the taxpayer. <br />sign -; �,��A,� <br />bsrs rer signature, ; Title Date <br />AuthOtizad Sign u Title Date <br />IM ATMMXW MMICE(S) Or TAX LIEN (Olt TgUINATION) IS (ARE) TO BE ft FILED QT MLY tt;I'!}! <br />>Ot O DBMS& Y <br />Tli>r DOCUYMT(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 />GOLDEHRM TO BE DEPT BY THE REGISTER OF DEEDS. <br />BILLING IS TO BE ONCE PER MONTH AND THERE WILL BE NO Pp.E- PAYMENT OF FEES. <br />THANK YOU FOR YOUR COOPERATION. <br />SVpo+acdos 4 -094 -14 Rev. I -al <br />f <br />I7 <br />j <br />r <br />Additions <br />��p Of <br />Asatmertt Ous <br />M I nation of the amount snown to be due. and the taxpayer has failed toiipay the amount duels terdemand to to s Notice of State Tax <br />Lien is an extension of an effective lien it serves to continue "- priority of the state's interest in the affected property of the taxpayer. <br />sign -; �,��A,� <br />bsrs rer signature, ; Title Date <br />AuthOtizad Sign u Title Date <br />IM ATMMXW MMICE(S) Or TAX LIEN (Olt TgUINATION) IS (ARE) TO BE ft FILED QT MLY tt;I'!}! <br />>Ot O DBMS& Y <br />Tli>r DOCUYMT(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 />GOLDEHRM TO BE DEPT BY THE REGISTER OF DEEDS. <br />BILLING IS TO BE ONCE PER MONTH AND THERE WILL BE NO Pp.E- PAYMENT OF FEES. <br />THANK YOU FOR YOUR COOPERATION. <br />SVpo+acdos 4 -094 -14 Rev. I -al <br />f <br />I7 <br />j <br />r <br />I7 <br />j <br />r <br />