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<br /> - YNDIY�DUAL INCOM£ TAX
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<br /> h�_�:; • TAXABLE YEAFt 191C �GRAND ZSI.AND N� 68801.
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<br /> .'�"�=- � ''�' ,�" � DATE OF I�OTYCE 03/09/A�i
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<br /> � "° � . INS7RUMEN7 N0. ,•:�`•�+Y��':y
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<br /> � � PURSUANT TO�TME REVENUE I.AMS OF THE STATE OF NEBRASKA� NOTICE i5
<br /> i� . ��°" � HERESY GYVLN BY ?HE NEBRASKA D�PARYMENT OF REVENUH THAT YH� =_=
<br /> " � , STATE TAX 1.=EN NHICN HAS BE�N DULr FIL@O A6AINST YH� ABOVE NAMED `�"-`-�-
<br /> � . �� TAXPAY�R FOR ENDYVIDUA� INCOME TAX�S IS THRM7NAt�0• �'�' h�-°
<br /> " I H�R�BY CERTIF1l TNAT THE NBBRASKA DEPARTMENT QF REVBNUE NAS COMPLIED �•�� -�—
<br /> NITH THE REVENUE LAWS OF TH� STATE OF NE�RASKA IN TH� �Et�RMYNATIGN OF •s ° -
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<br /> � NHBRA6KA CEPARTMENT OF REYENUE—White end Cenary Coples TAXPAY6R—Plnk Copy COUN7Y—(ioldanroQ Copy
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