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Notice of State Tax Lien M l 101+avenue Litn Sala1 Number Lttn Type - Date ..� .... -- -- - - Social SfCuTIty Number 89eeew 104927 Original , 88239080 ❑ Renewal 9-11 -89 505 64 3485 Nebraska 1.0. No. County LifKt F1114 With Spouse's social Security 2994$193.. Hall Regttter of DMd NuM 40 8537 - - atTCm"k gt3S {NESS NAME AND LOCATtOtti A�DRE55 - - - TAXPAYER NAME AND MAILING ADDRESS eusjri#UName trams Robert A & G Clare Burke Street Address Street 2115r Mailing eer t Blvd city Stalo Zip Code City State Zip Code Grand Island, Ne. 68801 This Natim or. State Tax Lien is issued by the NebraAa Department of Revenue for unpaid =CS pursuant to the Tovenite rows of the state of Nebraska. Notice is hereh wren that taxes including penalties and interest, which are shown.6etaw,, arl 'due from the taxpayer sgedfx4orr �d remain unpaid after demand. These taxes constitute a lien in the counplAcr real and personal pry $ to the taxpayer or hereafter acquired. TOTAL E.' 216.79 1 hereby certify that the Nebraska Department of Revenue has Compliec vA*j,. the revenue laws of the 5`.ato of Nebraska in the det:a.- minatlon of the amount shown f.,:. , uo• and the taxpayer has failed to pay the amou z; tkse after demand. If this Notice of State Tax Lien Is an tenslo of an effb -Mtr.e :+ it serves to continue the priority of the state %:j:t'., ,sst In the affected Property _t the taxpayer. sign Revenue Serd or Agent -heft r Parer Ignature Title — C — Revenue Agent Supervisor s• Authorized Sipnatu Title Cate N FOR COWM, "OFFICIAL'S USE NEERASKA DEPARTMENT OF REVENUE —White -4po Goldenrod Copies _ TAXPAYER -- Pink Copy COUNTY OFFICE — Ctnary Copy SIR B,TlB<'B� I�C1r(S) OI• TAX LIM (Olt TI11FI101TION) IS (ARE) TO BE FILED-00W 0129 go Iddep R W DEEDS. THE DOCOUXT(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 L DEPARTMENT OF REVENUE. GOLDENROD: TO BE KEPT BY THE REGISTER OF DEEDS. SIULIM IS TO BF, O14CE PER HONTIf AND THERE WILL BE NO PRE-I'AYHEtiT OF VEF.S. %1ANK YOU FOR YOUR COOPERATION. Tact Catewwv Tax Period „ ,`� ;�,: AmO" `` `}Yam Penatri Iri;�trlStt� Additions galaltctlof Auwanertt Dom Numtlar AssastnQ f .. TOTAL E.' 216.79 1 hereby certify that the Nebraska Department of Revenue has Compliec vA*j,. the revenue laws of the 5`.ato of Nebraska in the det:a.- minatlon of the amount shown f.,:. , uo• and the taxpayer has failed to pay the amou z; tkse after demand. If this Notice of State Tax Lien Is an tenslo of an effb -Mtr.e :+ it serves to continue the priority of the state %:j:t'., ,sst In the affected Property _t the taxpayer. sign Revenue Serd or Agent -heft r Parer Ignature Title — C — Revenue Agent Supervisor s• Authorized Sipnatu Title Cate N FOR COWM, "OFFICIAL'S USE NEERASKA DEPARTMENT OF REVENUE —White -4po Goldenrod Copies _ TAXPAYER -- Pink Copy COUNTY OFFICE — Ctnary Copy SIR B,TlB<'B� I�C1r(S) OI• TAX LIM (Olt TI11FI101TION) IS (ARE) TO BE FILED-00W 0129 go Iddep R W DEEDS. THE DOCOUXT(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 L DEPARTMENT OF REVENUE. GOLDENROD: TO BE KEPT BY THE REGISTER OF DEEDS. SIULIM IS TO BF, O14CE PER HONTIf AND THERE WILL BE NO PRE-I'AYHEtiT OF VEF.S. %1ANK YOU FOR YOUR COOPERATION.