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U &80061 <br />y <br />1 <br />INSTRUCTIONS <br />PURPOSE OF FORM. This form it to be used by the Nebraska <br />Department of Revenue for the purpose of notifying the appropriate <br />county authorities that a Notice of State Tax Lien is being Ned <br />against the taxpayer indicated on this form. <br />The tax category number codes and the Nebraska tax programs they <br />represent are listed below. <br />01 ............................. Sales Tax <br />02 ......................... Retailers Use Tax <br />04 ...................... Consumers Use Tax <br />10 ............................ Pad- mutuel <br />21 ................... Income Tax Withholding <br />22 .................... Individual Income Tax <br />23 .....................Fiduciary Income Tax <br />24 ...........Corporate Income and Franchlse Tax <br />36 ...................Documentary Stamp Tax <br />44 ............ Mechanical Amusement Device Tax <br />45 .......................... Severance Tax <br />46 ............................ Estate Tax <br />47 ..... ......................Cigarette Tax <br />67 .... .........................Litter Fee <br />68 ........................... Lodging Tax <br />71 .............Interstate Motor Carriers Fuel Tax <br />81 ............Motor.Vehicle Fuels Importing Dealer <br />85 .... . .................... Aircraft Fuels <br />91 ........................... Special Fuels <br />A . • <br />C�lCn <br />Z <br />0 <br />' <br />ea <br />�a <br />�m <br />� <br />a <br />� <br />t+D <br />N <br />tO <br />A . • <br />C�lCn <br />Z <br />o--4 <br />�a <br />�m <br />'A <br />CD <br />7S <br />3t <br />(a <br />vv <br />N <br />to <br />ca <br />1,12 - <br />t� Q <br />i <br />L J <br />n <br />L <br />{ <br />