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O <br />CAA' C Ic o0 <br />CHECK <br />REFUNDS: <br />CASH <br />CHECK__________ <br />HALL <br />u:s t 2623 0 0 8 8 <br />:.. . , a�•I ti:.%! . HT1 <br />r <br />RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />P 0 BOX 94609 <br />LINCOLN, NE 68509 <br />RESERVED FOR REGISTER OF DEEDS RECORDING SPACE <br />(Sec. 23-1503.01) <br />HALL COUNTY, NE <br />