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r <br />h <br />U <br />L <br />trze,.�.n.ni <br />F <br />Notice of State Tax Lien <br />0 Read Instruetlons on feyaae We <br />LIGASeriat Number <br />Lien TYPO <br />oat& <br />SOCiiil SaCtIfity NantWr <br />Penalty <br />Interest <br />original <br />22 <br />01 -01 -84 thru <br />12 -31 -84 <br />01 -12 -89 <br />89062045 <br />0_ a.new }I <br />6 -27 -89 <br />505-54-4656 <br />8g 103594 <br />89. <br />Nebraska I.D. No. <br />County <br />Lion filled With <br />speulwssocial security <br />85.64 <br />2754537? <br />Hall <br />X Riijista► of need <br />umber <br />County Clerk <br />SWINESS NAME AND LOCATION ADORM <br />TAXPAYER NAME AND MAILING ADDRESS <br />Buslius" Name <br />Nam• <br />Jahn 1. Milli <br />Street Address <br />Street oS fa*. ,er Mal11n:i rah- �rgiq� <br />r� <br />811 West 11 tea 'Street <br />City <br />State <br />Zip <br />Code <br />City <br />_ <br />State zip Code <br />Grand Island, <br />N6 68803 <br />Thin Notice of State Tax Lien is seined by the Nebraska Departlmof of Revenw. for unpAd Taxes pursuant to the <br />t+tv"w laws of the state of Nebraska. Notice h hemby given t1t it. taxes inchWikv perialties and interest, which are <br />dk>?e a below, are due from the taxpayer specifk -4 ergs and.retnain unpaid afietr tlemalyd. Then taxes omstitute <br />a Hen in the 9fl anty fn real and personas, ert� W. g to ft taxpayer or hereafter acr;mt clkd. <br />Tax <br />fat �y <br />Tat Period <br />Date o!� <br />Anownent <br />Amount of Tax <br />Penalty <br />Interest <br />Addition» t� Due <br />Aammemet <br />22 <br />01 -01 -84 thru <br />12 -31 -84 <br />01 -12 -89 <br />232.80 <br />11 464 <br />136.97 <br />381.41 <br />22 <br />01-01-85 <br />12 -31 -85 <br />10- -88 <br />191 QO <br />9A5 <br />85.64 <br />286.19 <br />FRI <br />-Fo ,FAt_ s 667.60 <br />1 hereby Certify that the Nebraska Depasinnent of Revenue has Compiled with the revenUO law& el't;rae•5tate of Nebraska in Me dater. <br />sion of the amount sr,own to be Cue, a "a the taxpayer nas ra,fea TO pay the amount Cue aster Ciim Ind. If this {Notice of State Tax <br />Lien If an extension of an effective flan it serves tr, continue the priority of the state's In ttdRff*c14d Prop". of the taxpayer. <br />Revenue Age, t Su ry 19, S 9 <br />I� ePan i afore Titie Date <br />Re!re�ue Agent Supervisor • �Z - <br />ti Authorized Signature Y,•;rs date`). <br />FOR COUttTY OFFIVA 41S USE <br />NEORWA DEPARTMENT OF REVEINUE - Whiteanll GoichritodCopies TAXPAYER.-- Pink -Copy COUNTY OFFICE - Cenary Copy <br />"W' 14t7 ICUS) OC TAX LIM (OR TEplMATION) IS (ARE) TD 09 FILED ONLY WITH <br />T%s Itkif3=*"'M or O111M. <br />THE DOCtJl EWNS) IS (ARE) NOT TO BE FOMAADED M TFM MUNTY CLERK. <br />DISTRIKITION OF COPIESs <br />MITE: To BE VALIDATED BY 711E RFCISTER OF DEEDS AND RETURNED TO THE <br />DEPARII!!I?i'r nt: ANF.t I--. <br />GOLVE10130t TO BE KEPT Of THE ROGISTER OF DEEDS <br />8]'.1J" "G IS W BC ONCE rER "MI AM THERE WILL BE NO PRE- PAYKENT OF F'F_ES. <br />THANK YOU rOP YOUR LOOPERATION. <br />t+�q <br />-i <br />