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<br /> • . INDiYIOUA{. INGWIIE TA�I
<br /> SOC�•SEC� MO• 50876�454 93� ' '' ' �
<br /> :d ' t�B�. ID�NT• N0+ 228'38933
<br /> �� 'b�OtJSE i0C• S�C• NO• S06a03729
<br /> i` tAXA81.F Y�AR 199Z
<br /> • I.IBN N0. 93?160353 JAMES 0 � .IONI R HENDRICKS
<br /> COUN7Y NA�
<br /> . '�; �' DATE Of= NO?ICH 08/O6/93 3008 ?YH AYE
<br /> �+�Irs� /bAT� OF ASSESSlIENT 03/l9/93 CO a41JFfS � IA 5i'�03
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<br /> "�-,�;.':,:,:'=��:-� THIS NOTICE OP StATE TAX LIEN IS ISSUED BY T11� N�BRASKA DEPAit7MENT OF
<br /> "� ,�;:�:,,,;;.,,�. ,..,,. � aEYENUE FqR INDIYIOUA� INCOME ?AX PURSUANT TO�TiI� aEY�NUE LAMS OF TNE
<br /> �• ;��;_ ' ' ' S, � ,��.; STAT� OF NEBRASK4. !lOTICE IS MEREBY GIVEN• THAT� INDIY�DtJA4 INCOMB
<br /> ,Y.,._; , -�- ���•� TAXES INCLUDINC PENAL?IES AND INTERESTs YNICN ARE SHOYN BELOM ARB DUE
<br /> ''' ' FROM Y11� TAI�PAYER SPECIFIED ABOVE AND REMATN UNPAID A�TER DEMAND.
<br /> t ��.- `� '•`":�° THESE TAXES CONSTITUTE A LIEN IN TNE COIJNTY FQR PaOPEitTY BEWNGIN� TO
<br /> ; � • . THE TAXPAYEit OR liER�AFTER ACQUIR�D.
<br /> ' Al1�UNT OF TAIf . . . . • . . . . . . . . . . . . �. . . . . • 273•00
<br /> ' PENALTY + � � • • • • • a • • • � • � • • � � w • • • • � . �3.b5 �
<br /> � � •`��'`�' �NTEREST (COMPUTED TO �8/06/93) . . . . . . . . • . . . . . 5•92
<br /> '� •�� � TOTAI. AMOUNT 01� • • + � • • � • • • • • � • � w � � • � • 29rZ�57
<br /> , .
<br /> � . � � I HER@811 CERTI�Y THAT T�I�C NEBRASKA D�PA(tTMENT OF REVENUE HAS COMPLIED
<br /> � . � � MITH tH� REYENUE LAMS OF ZHE STAt� 0� NffBRASKA IN THE DETERMINATION GF
<br /> � TNE AMOUNT SHOMW TO B� D�IEs AM�1 �'N� T�XPAVER HAS FAILED TO PAY tHF
<br /> . � AlWIlNT DUE APTER QEMAND• IF 7'NIS NqTICE OF STATE TAX LIBN IS AN
<br /> EXTENSION OF .AN EF�ECTIVE LIEN IT S�RYES TO CONTINUE THE PRIORIT1f OF .
<br /> . � , tHE STATE�S INtEfi�ST TN THE AFFECT�A �' EitTY Ot� TN�TAXPAYER� �
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<br /> � �� ���•' PREPARER�S IGNA7URE �LE DATE/TEI.EPHONE
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<br /> , ��, 9-/3 93
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<br /> �� ` ' AUTHORIZE frNATUttE IZL� OATE �' �
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<br /> � . FOIL COUNTY OFFICIAL�S USE
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<br /> ' NEBRASKA DEPARTMENT OF REVENUE �-White and Canary Coples TAXPAYER—Plnk Copy CQUNTY—Ootdwttod Copy
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