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r <br />Or.g.b=h, <br />r <br />Notice of State Tax Lien <br />�eaW rw «,Mtnw. nw r�weY firie <br />lien Setlai Numbel <br />Lien Type <br />Data <br />Sotlal Set urlty Numbe► <br />PeanttY. <br />interest <br />/t�dditidrw <br />0 Original <br />; .. <br />Assessment <br />9/06/269 <br />1 Renawai <br />6 -15 -89 <br />r-- <br />$�.... �, i13+e� a� Q <br />Nebraska I.D. No. <br />County <br />Lien Filed With <br />spouse`s SOCI4I Security <br />4079914 <br />Hn11 <br />© Itaillster of DWI <br />umber <br />0 County Clerk <br />•USINE= <br />NAME AND LOCATION ADOREii <br />TAXPAYER NAM+ AND MAILING ADDRESS <br />Swine" Name <br />Name <br />J. H. <br />K. Inc. <br />Street Address <br />Street or Other Mailing Address, <br />P.O. <br />Box 1214 <br />City <br />State <br />Zip Code <br />City <br />State 21p code <br />68802 <br />Grand <br />Island, NE <br />This Notice of State Tax Uen is issued by the Neb'r*GM Department of Revenue for unpaid taxes pursuant to the <br />revenue laws of the sate of Nebraska. Notice is hereby Riven that taxes Including penalties and interest, which arc <br />sbulwn below. Are due from, the taxpayer specified above and remain unpaid after demand. Tbese taxes, constitute <br />a lien in the cottnty for rak altd personal property belci q ft to the taxpayer ar hereafter acquired. <br />Tax <br />CawwY <br />Tax 1101 <br />Date of <br />Amount of Tax <br />PeanttY. <br />interest <br />/t�dditidrw <br />BaWAS of <br />At�tearnent Dee <br />; .. <br />Assessment <br />r-- <br />07 -01 -87 thru <br />12 -31 -87 <br />01 -01 -88 thru <br />TOTAL <br />1 hereOy C*.T.Ify that the N'abrasks DeOartment of Revenue has compiled with the revenue laws of the State Of Nebrasl� in the deter, <br />>'1• minatlo/► at: t- aunt sh w to be due, and the tax ayer has failed to pay the amount due after demand. If this NotlCO of State <br />-Tax <br />% • T I.IM is an qn Of an <br />__act <br />ive lien Ws t0 CO sinus the priority Q•t the state's Interest In the affected property of the to %palsen. <br />. t Taxpa twice Spgeja1j4t--ea "'►Zd'� -;- ' ; <br />�.� <br />11151 ure Title Gate <br />s <br />I IF iftuthorized Signature Title Oate <br />FOR COUNTY OFFICIAL'S USE <br />NU ~A DEPARTMENT OF REVENtlE„_;_W i¢A#4aol_¢snrod C__Eo los .. TAXPAYER_ Pink Copy COUNTY OFFICE l linsr.V Copy <br />2= AMC= MtgtlA40) Cr UX UM (CO 1011) IS (ARE) TO BE FILED M 1a211 <br />go <br />THE DOCUUM(S) IS (ARE) NOT TO BE FO WARDED TO WM COUNTY ar LM. <br />DISTRIBUTION OF COPIES: <br />WHITE: TO BE VALIDATED BY THE REGISTER OF DEEDS AND RETURNED TO THE <br />DEPARTMENT nr rrVF.Nr1-!. <br />GOLDENROD: TO BE KEPT BY THE REGISTER OF DEEDS <br />DILLING IS TO BE ONCE PER MOWM AND THERE WILL BE NO PRE- rAYMENT OF FEES. <br />`.J 'ANK YOU FOR YOUR U(PUli-4--RA'Y104. 7 <br />