|
.:��
<br /> -�=��c-�-{�������a,;;.•�i-r.:t:y�.,. :�-, � � - ut �- ::f:�i.a +' ";��'
<br /> -.t.�
<br /> r--�i rre s�,srt..:��� �- -�-
<br /> - —:.Mio.;..71F�"i_:- '�_.�`--
<br /> .. •;�cTr:v�,�.:;'�n4:'�.av *.�V�R�-..
<br /> �Y_.�►�X vti°^.�'!�. - - -`--- �.__ _�'�'i:��.�..,..,.._�.
<br /> X� --.. - - - - — -- .'k:•'•+�'-".'�l. ,.,;,;;�.�7R�k„li-v�c_
<br /> - __� ..uc..ic. ��.. ���11 - --- -- i-=-=-� '`" --�=��, .y M'�.-,.
<br /> �, . .a, , +�
<br /> _ _ �..�� .
<br /> �-,evcwv,�;;.an�r�y5,�-,�,=:.� .�• -
<br /> .�,....._ � •_r,---
<br /> _ .-•.��.� - ---- - �- -- ..
<br /> . �sri.,�.�.rr,yA�l,�p{t� � —���:--- - . ---_- -.. --_-:.. -
<br /> T. _ . . -. - - -- --- �-- -- '� .. .. .. . _ -_-. .
<br /> � .. . --��,--'�-^cr":—rf�-T. '� . . , _,.•".�.
<br /> .h� _ -1 . .�,, .�6:� � , i., ^ . ''-S • •�';.l�y..4l7�sii_,.1�'!��•'=...u�- r.wrax°
<br /> ,». . •.,,. . , ' _.... ' ' , ':t�,,,�,s:r .�'s�.
<br /> • `v� �I���� `� �• . - �$. . . .Ul%�rnilw,:�.��iV�t�.riACc•�.�.�:.yr--�r,v z.-1,�-
<br /> �� ••:•,..--
<br />�- . . . , . .. - aY.`L.:...tP•.3' ' J. o�.�
<br /> � h » �� , '. �� ' � � � ,�� � ' • ���sj..'w'.I��zSa�
<br /> ��• �wi� .. . ��;� �' _ . .2. 2'�:iF rt1q�v - _
<br /> � j �����`ty- T-�:..,rg.,,,u:
<br /> ..�J .• �, �� ���' �� ���� .. ��/��y��� �! � .� .. . 1 - . , .i�`'Irl
<br /> �f ,t� irVY��Y�� ��Y , ,° n����,, . ..Y-•�+;i;.
<br /> �N•NO��� ! T� ' -- ���';{�'�"�"�`
<br /> L��1i RELlAiE IiO� 9�3di042Z . �� . � Jw�,'r�:�
<br /> J .���'lfOTICE i6/3 . '= �"�: � . :�,"��._
<br /> . ..
<br /> �d'x'l�d.�.ZL� ,. ,� . , �,'', ,
<br /> „ IMSTAIM�/IT N0. ., • ••••• � ,
<br /> - . �LMt�UAMT T'0 TME REItEIi�l� 4AMt OF T116 STATB Of� NE�RA3KAt MaT�CE i�� : . .
<br /> � NERE6Y CIVEN dY TNE NEdRA�ICA DE!'AR'i�ENT OF REVF�t!� SMAT �liE � .,�,
<br /> � .. StATE TA�i �IEN Mi�I�N MAi 6EEti DW.Y FILED AGA2MST tHE AiQYE NAl�! '
<br /> TAXPAYER FOR �NDIYIDUAI. IMCOME TAXES IS TERl�YATEA• ' �
<br /> �� I HEREbY CERTIFY TI�AT TNE NEditASKA DEPARTMENT OF REYENIlE NAS COlIMkYEO �
<br /> MITH TiIE REVENUE t.AMS QF 7NE STATE Q� .NE6RASKA IN TNE DETERJIINATIQfI G�
<br /> T1iIS T TIGII. �
<br /> � �/(,( s�-� Q�s��
<br /> _ •��• a����+• •��" •���•���• w N���� ��• ���i �� •
<br /> oARER�S Tt1aE TITLE DATE
<br />.=.'_ .
<br /> - _ . . ..... . . . �•� �.r.��•.�ii.•. .
<br /> � A THORIZED S NATURE ITL �DATE ' :
<br /> :�: I . .
<br />:;�� .
<br />;1'; FOR COUNTr OPFICIA��S USE �
<br />_�� �� � �
<br /> \ � ' +
<br /> r � �w � .. �•, '- f ) ti7 V^.- �
<br /> _. _1 . .a. ��� �~ � �
<br />. _ • � � 4 , � J • • .7
<br /> :;`�Y �1�:. .' . � � • �� ..� � .� �
<br />_- 1.r^• °4}� .. • '', �t't � d
<br /> � . • �
<br />..-_�.ruc��xf� � �� � • . , � Q _.
<br />:;O_���i�'::�.fi1 _�^ � . .. '• 'f.�
<br /> �� ,x tf,rd.i,7.,,�' _ �,� ti7 • fn' � �
<br />� _ -y�',$;, • : � �i� � _
<br />. , ti.%::FR�hr�Y'�ti���� O -
<br /> �,.. _�S . :1y�i � __
<br /> �i:
<br /> ,'• '�::i."���'��i' � N66iiI18KA dEPARTMBNT OF HEVENUE—WNI�1nd Cirwry C�oWes TNtPAYER—PkYt Copy �COUNTY�-OoNMnod Copy _
<br /> ... . ,'N�`�,. 7-0�bf�RM.� _
<br /> :t>_ �p!M�d��0�� i1qwMON 7•1�61�RM
<br /> i ._R� -_
<br /> . iµ..',;;�= i'i.
<br /> _ _ �pn{.•r•�..�r-y--� . ,. -o �� . r-v:.a-�-re't,�•,T. , .. . . .�-�t�-s-yo�E:±�!r�-
<br /> .., . - � �•,��.1�,��� r� ' � • � , ' 'Et '�" . ' .
<br /> } ,�. ;:.t, , ' . .�'S7'�:; .. .. , .. , _ • - 7 J�'k'��y'�t+...:.n � _. .� -., s . .' . '- '. . . .
<br /> � .
<br /> ,. , . . , . .
<br />-.... � .. _ .
<br />' .�` ',.Y 4 a. '<.. . . . .
<br /> = - __ :. _..� ..
<br /> .,
<br /> < :
<br /> - - - - - - - - -� , .,. -�- - - --
<br /> -- -- -- °--- --- - — - -- ---- -
<br /> �
<br /> F -- --- - --
<br /> . . T
<br /> < � .�• ,. . ., s _ . . �
<br /> '.� ^..x`!�'?'�q�i` '� � ,
<br /> i�: S�r.•
<br /> .:'�^.?,�... . . •
<br /> -_ Q=o�:1'�' �l„ ';-• . ... . • .
<br /> _ -,�iW1�A�'('�7�i.T.a:L-U����`+ti:M": - . "'"'"'_ " . � . ' .. . - .. , . .-
<br /> _" �.e�crwwtiu"+vj'�".' .. . . ^ .. , .
<br /> � �'�Ji�'_..A.t-.':,+ . ' . . . ' ..
<br /> �_,__.._.�:��y_.� . .. .
<br /> __, ..�.�i t.. � ' . . -
<br /> .� ` ��'„ry','�� �. � ' � ' , . . ' . ��a.�i�"eJ' � ,
<br /> . . _ w ,�.. -�rn.
<br /> - . . . � . .r�,�'Gi��H.:_ +' .
<br />. _ �.T.•,�;x�._rA..qq .. . .. ._ . ,e .Y �, n , . . , .. . � . �
<br /> ,
<br />���� �.
<br /> „ . . .
<br /> • ' ..
<br /> �: �.. . . . .. � � .. .
<br /> .. �� .
<br /> .. � •A. . -� . .
<br /> � . �
<br /> Va�__�_M��. __. _.__ ._ .___
<br />
|