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�� <br /> �, �����+� <br /> ���� <br /> 99 1109�1 <br /> f�ic,�.il <br /> !dt �;'L� iii1� <br /> �� �x�u° 1 � ::3: ��`•�� <br /> Sf,�il' Si��?� <br /> . � <br /> � No#ice of StatQ Tax Lien <br /> � <br /> � <br /> ��� <br /> ' �►se oo Nar w�ir�in sras sPace <br /> This Notke a[5tats Tvx Leo is isaued by the NebrASlc�lkpartment o[ � <br /> Rev�nue �br uopaid b�acs purs�aut W the �eaue l�we of the state of <br /> Nebraslu. Naace is Lereby givep that taxes lnciuding psavltiea �ad <br /> inte�est, �rbkb are sLoan� below, are dna from t6e taxpayer spectl�ed • <br /> belaw eod czmaie uopaid��ler depasnd. These taaes coastltutt A lien ia <br /> the oouqty tor reaE and perBOna1 pc+operty belvngidg to the taxpayer or <br /> 6eratlec acqui�ed. <br /> hlebra8kp W�ntifirration NumCar tJen FlIeO V�itl� Sociai 8ea,rity or Faleral LD.NumDer Spousa's Soclal Securipl Number <br /> 812 9 8 S 1 Fle9ister ot oeeds Cl��+flr c:�ertc 6 2 0—I6—31�7 <br /> Lien s6rial Numbar uen�ype arco af uon coun:y <br /> 9/10/3 4 8 �+g+� ❑����n Q�rreotod 10—�1--14 9 9 HALL <br /> B�JSINk$$N�►ME ANO LOCATION ADDRE$S TAXPAYER NAM�ANp MAILING ADDRE55 <br /> eusinass�damr �uame <br /> �os� � rsaLZNA <br /> Street AOdress 8treet or Othe�Mai�rg t►►erermss <br /> . 4 2� s r�.��i soN <br /> CRy 9tata �ip C�otle CRy 9tate z,p Coea <br /> GRAND xSLAND NE 68$O1 <br /> � Tax PaWod � aneunt ef Tax Penelty IrMrrrst Addltlona ���nt Due <br /> C��Ory <br /> 04-0 —99— <br /> Oi 05-37�99 1�-31-�99 60Q.Ofl 120.00 14. �9 734. 49 <br /> 21 05-3�.-99 10�31—�9 100.00 25.00 �.27 127. 27 <br /> Retum to: <br /> STATE OF NEBRASKA <br /> DEPARTMENT OF REVEI�UE � <br /> 7811 WEST 2WD ST STE 460 <br /> GFtAND fSI.AND NE 88803 TOTAI. $ $��. '7� <br /> I hereby oeMy it�at the Mebreska DeAartrnene ot Revenue nas wmpped wim tha revenua laws ol the 9�c�ot NabrasKa in the determination <br /> of tne amourrt shown to be due,and the taxp�ayar nas tailod to pay the d�ue dRar d�mand. If this Notica of Ssate Tex IJen is an aztension of <br /> 811 Af�9CtiYe lien,it SO 0011df1U�th�Pr+��f tl16 st�'a i SI19 9R9C�ed pfOp�ly Of �7tp��, <br /> sign � ' ��� �9 t�a��-�o,� <br /> '�T��9 re e , T� <br /> her� , � �, � <br /> �� <br /> NEBRA8KA DEPAI�TME OF R�VENtIE• i1e and Goldenrod Copies TAXPAYER•Pink Capy COUNTY OFFlCE•Canary CopY i <br /> a.oa�.a.r.,096 suoeiaea�.-�9a�aa Rav.s� <br /> �""bdi�'i2''d°'�"' NGISi,hIQ .:i'�'fl W�E�:�� 66. �i !'sOhJ <br /> _ __ _ � <br />