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<br /> PLFA8H QO NOT WRRE IH THi9&PACE
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<br /> INDI'�IDUAL INCOME TAX �.;:`"'����=
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<br /> :'��;;�; SOC. SEC• N0. 505��9353 �'=��`-
<br /> ,,�`.,, NBelt. YQ&�IT• N0. 3�Jl�614618 �=�_.
<br /> ' SPOi1SE SQC• SEC. NG. �r �;;�__
<br /> .. .��' TAXJIB�E•YgaR 9834500�6 �.v_
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<br /> _ °.-�., , CGUNTY NA�L !lAitTIN J CABA�LERCJ -
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<br /> IflATE 0� ASSLSSI�I�4VT 10/26/1998 GRANB�YSLANI�E�N����8�01� �--
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<br /> ,'��=�� ?HIS N04Yf.E QF STATE TAxS �YIEN IS ISSUED B� THE NEBRASKA DiE�AttTMEN4 GF _
<br /> ''�'" � REV�NUE FOR INDIVIDUA6 YWC�ME TAX P6JRSUANT TO 7HE REYENUE LAMS OF THE
<br /> �� " , r� STATE �IF NEBRASKA.� �IOTICE 3S HEREBY GIVEN THAT IHD�VIDUAL INCOpH
<br /> ° �'�', ?AXES IPICLUDItd6 P�d�ALTIES AND ZNTERESTs �HICH AItE SHONN BELOM ARE DUE --
<br /> I F t t O N T�E T A X P A Y E R S P E C Y�x E D A B G I I E A N D ��MAIN UNPAIA AF4�R pEMAND.
<br /> • ;!;�� � THESE 7AXES GONSTYTUTE A LIEN IN 7ME COUNTY FGR PROPERTV �ELaNGING 70 -
<br /> '� THE 4AXPAYER OR HfsREAPTEtt ACQUIRED. �i88•0�
<br /> � ' AM�UNT Q� �'AX • • • � s • � • • � • � • � o e s • _ —
<br /> . .. � PENALTY • � � • • � • • � • • • • • � • � � o • � 24�40
<br /> INYEREST (GOMPUt� TO l2/il/19518D • • • • • o • • 160•64 —
<br /> _ ,.,�, � 7q4AL AMGUNT DUE � � • • � • • • • • • • � a • � 6�3v04 __
<br /> I HEREBY CERTIFY THA'� 409L NEBRASKA DEPA63YO+lEN� OF RLVEid�D� HAS COMPLIED
<br /> MITH TH� REV�NUE L�MS G� THE STATE �F N£SRASKA �B� TNE D@TERMINATI�N �F -�-- -
<br /> " 1HE AMOUB�T SHOi1AI TO BE DUE� AND THE TAXPAYER NAS PAILED TO PAY TME
<br /> � 1tMOUNT At�� AFTER DE(�AND+ IF THIS NOTIGE AF S7ATE TAX 6IEN IS AN =
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<br />�j . ._ _�: EIiTE6�5I0N OF AN EFF�CTadE LIEN xT SERYES tG CGNTINUE THE PR�QRITY ��
<br />=_ = _- � Tt{c 53A�'��� 3l���g�5� 3fil �HE �.�r���'��L �+n���ESY t�:' �'nL T��'�7�l=0 �_-
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<br /> PRE�AR� �S IGNATURE TY E �DA1�/i'BLEPNONE ��-�=���:.
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<br /> Al�THARIa€9 SIGNATURH T Ti£ �aZE ���'���
<br /> NEBRQSKA OEPARTMENT OF REVENUE—Wthfte Md Cenary Coptes TAXPAYER—Pink Copy OOUNTY—t3o�donrod CoPY � -
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