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<br /> I.ienBariilNumber UenType � Date &odW&ocutityNumGsr .. °`-
<br /> ��88�ru1 '. � i�.:
<br /> Renewal 5Q8 5G 1�9 ��
<br /> ' NaDrqsfc�I.D.No. County Uen FNed With Spouse'a SoGel&eadty Nurrbw ,�
<br /> ' ' , Y906437 Ha11 pco��'iycia�e� �r '
<br /> BU81NES9 NFIIWE AND LOCATION qDDRE.iS TAMPAYER NAME AND AIAILIN(�i AODAESS � �`
<br /> , Bu5;n9saNamB �o — - r.,
<br /> Ronald L. Juracek �'�`
<br /> � 6:reet Addrou Streot aQiher Me3llnp ANlree� �
<br /> ?_530 St. Patrlck AvenuE � " •''�
<br /> . Glb a^tate ap Code City 6tets �p coM � e
<br /> � Grand Island NE 688�D3 �+�
<br /> . T�;91YoLce ef Stete�'�z LtcA!,l�ucd by tha Ive6resR�B�pu�ae;,t of�teve�ue forr w�ps�l�laxr9 purauant to tlne � ..
<br /> - revenue laws of the state ot AIebras{ca.Notice Is hereby giventbat taxes including pen�ldes and lnterest,which cre �_'-
<br /> ahawa below.are due from fhe ts�xpayer specitied above and rematn unpvld after demand. �6ese Uuey constttute � � ' _
<br /> ° o lien in t�e coanty for real and persoaal property belonging to the t�upayer or he��eatter acqufred. � ",
<br /> Nut�qorl► T�x P/tM�d �a�t Mtount ot Tax Pen�ky Intsrost Additbns ��,s��� '�;,-;
<br /> mo�r
<br /> ;i�.l
<br /> .. 99 _ 2�19.31 251.93 24•16 5.00 2,800.40 � :�
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<br /> 1 - �9 400.Q0 17.49 517.n9 , �
<br /> 11-17-9 400.00 �._ `�
<br /> _ . � 10.43 470.43 �.____��.—.
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<br /> TOTAL S 3 7$8.32 , '�� .
<br /> �� ; �hirobyoortitythattheNobraskpDeQaRmentofRevenuehasoonpliedwfthlAaravenuelaw��lthectatoofNebraskelnthodetomilnntbn � ` �
<br /> ot Iho arnount shown to be dW,end the taxpaytt htis lo:{9d to pay Ne anaunt due artor demand.It NI9 No'�Icn ot Stato Tax Uon ts an oxtensbn of I ��
<br /> nn eNective Ilen.H serv e Ne prbdty ot iho etato's Intorost tn Iho Mected property thp Iuxp�yer, • �,
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<br /> � here ���ers� �� D���i -� I , ,.,: ,_
<br /> �`) u� a-�y C ! ,
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<br /> Authoriz Ignaturo Titlo Dale ` rti
<br /> FOA COUNTY OFFICl/tl'8 USH � � ��,
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<br /> NEBRASKA DEPAATMENT OF REVENUE-Whito and Go(deRrod Coptes TAXPAYER-Pink Copy COUNTY OFFICE-Ccmary Copy
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