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` ` .- _ -. - -. -- - -- :. __.� t ` _ _. _.•_ � , it ,t s or _ _ . - ., ...... ,. .�Rwd i�s>�,ettona oir ":a`+rerea fide • - - i Notice'of-State Tax Lion �— Lill! 3irtat f!fumtiK L.ieq'1 y0i !S�– - - Fra. Q Orfurnat vide w ❑ Renewal 8+23-90. 1!�ebraeka t.[f_ Nb. , County LlenFitetrwltir o SKurity Register of Deed 1 {� 1 County Clerk A KWNM NAME ANO LOCATiOlLADORiSS TAXPAI/ER NAME AND MAILING ADDRESS .9ustness Name • , Name_ . #; Street Address Street or Other Mailing Address I 509 12th Street City State Zip, o'de City State- Rock, Island IL 61 Thin Notice of State Tax Lien is hwed.by the Nk w1w Department of Revenue for anpaid taxes pursuant to the revenue laws of the state of Nebttaka. No)ioe is hereby $l en that taxe$ including penalties and interest, which are' shown below, are due from the taxpayer specified above and retrain unpaid after demand. These taxes constitute a Sm in the county for leaf and petsonal property belongna to the taxpayer or hereafter acquired. , l:hereby certify that the Nebraska Department of Revenue has compiled with the rrienue laws of the State of Nebraska In the detet- minatlon of th unt show o be due. and the taxpayer has fall sy the antount due after demand. If this Notice of State Tax LIM Is an a on of an elfeCt s nit as t0 Continuo the p city f tha state's 1 Brest In the of CteO property of the taxpayer. - s 211 iisre r'f aturs tl Date Gl == __# h i ztr • • Authori2ed Signature; Title Date FOR COUNTY OFFICIAt'c tlsr THS ATTACHED NOTICES) OF TAX LIEN (OR TERMINATION) IS (ARE) TO BE FILED ONLY VI'1'!i THE REGISTER OF DEEDS. THE DOCLtMENT(S) IS (ARE) NOT TO BE FORWARDED TO THE COUNTY CLERK. DISTRIBUTION OF COPIES: WHITE: TO BE VALIDATED BY THE REGISTER OF DEEDS AND RETURNED TO THE DEPARTMENT OF REVENUE. GOLDENROD- TO BE KEPT BY THE REGISTER OF DEEDS. BILLING IS TO BE ONCE PER MONTH AND THERE WILL BE NO PRE- PAY14ENT OF FEES. THANK YOU FOR YOUR COOPERATION. NEBRASKA DEPARTMENT OF REVENUE –White and Goldenrod Copies I HArH v rn , ..wr. 4.494.74 Rev. 9.88 Suooriadee 4•$4a•74 Rev. 7-81 R