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! m z D <br /> T, rn� � � <br /> r-- � <br /> � °'� n � � � . <br /> I� = � ` ° ` <br /> (1 � `? � O --�1 <br /> �.. <br /> � C � � <br /> � � C � � � �° � "' (S� _ <br /> Q A' r�, � -< o � � <br /> Z � iV o � � <br /> ce <br /> . 0. ° � � z F-� fl- <br /> ;�� T m �' <br /> � � rn �' � � m � N <br /> r- � <br /> � a r D � N <br /> � <br /> � P 99- ��42os `� ° �.D � � <br /> � � � � <br /> � � <br /> �� � <br /> r Notice of State Tax Lien � <br /> �.�►..k' � C� <br /> �� � <br /> a� <br /> PLEASE DO NOT WRITE IN THIS SPACE <br /> This Notice of State Tax Lien is issued by the Nebraska Department of <br /> Revenue for unpaid taxes pursuant to the revenue laws of the state of <br /> Nebraska. Notice is hereby given that taxes including penalties and <br /> intecest, whic6 are shown below, are due from the taxpayer specitied <br /> below and remain unpaid after dearand. These taxes constitute a lien iu <br /> the county for real and personal property belonging to the taxpayer or <br /> hereafter acquired. <br /> Nebraska Identification Number Lien Fled Wfth Social Security or Federal I.D.Number Spouse's Social Security Number <br /> 7 6 9 8 9 9 2 �Register of Deeds ❑co�rny cie� <br /> Lien Serial Number Lien Type Date of Lien County <br /> 9/0 4/3 4 8 ��s��� ���n�atan ❑ �oRected 0 4—21-19 9 9 HALL <br /> BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br /> Business Name Name <br /> UNDERWATER PET WORLD & SUPPLY CO, INC. <br /> Street Address Street or Other Mailing Address <br /> 1201 S LOCUST <br /> City Shate Z.ip Code City SNate Zip Code <br /> GRAND ISLAND NE 68801 <br /> T� Date of Belance of <br /> Category Tax Period Amount of Tax Penalty Irnerest Additions <br /> Number � AssessmeM Due <br /> 08-01-97— <br /> Ol 08-31-97 11-06-97 646. 73 64.67 91.37 802. 77 <br /> O1—01-98— <br /> O1 O1-31-98 03-05-98 219.48 25.00 22. 73 267. 21 <br /> 10—01-97— <br /> 21 12-31-97 02-26-98 88. 84 4. 44 9. 75 103. 03 <br /> TOTAL $ 1173.01 <br /> I hereby certi(y that ttie Nebraska DepartrneM of Revenue has complied with the revenue laws of the State of Nebraska in tlie determination <br /> of the amount shown to be due,and the taxpayer has failed to pay the amouM due after demand. If this Notice of State Tax Lien is an extension of <br /> an effective lien,it sen s to co�nue the priority of the state's irrt in the affected pro of the taxpayer. <br /> i .� <br /> sign � ' �� ���1�'Goa � <br /> here �� s gnatu e Title Date Telephone o. <br /> ,r�.ru•�_ � ✓i td�� 7 <br /> Authoriz ture Title pa <br /> NEBRASKA DEPARTME OF REVENUE- ite and Goldenrod Copies TAXPAYER-Pink Copy COUNTY OFFICE-Canary Copy <br /> ��n1d°^""-�id�Q" n-as4-�a Rev.iass supersedes n-asa�a Rev.s-ss <br />