|
,..,„� . . "
<br /> . .� ,. .
<br /> � .�,.�wr� . • . . ..,..U�.,
<br /> � � � � �
<br /> �` ,tAieRlle�� . <, •�, '°?'.';�...`,i.';
<br /> °'eRql� ' �.'tir� ti��-
<br /> .- .t"o1�O,MA�S•�, � . � , _ _. ,• ."�. �lip'Ft�i+��� ._ ._':
<br /> , v`
<br /> --—--- -- '
<br /> •.•-� --�----� -.------- :.. _. ___
<br /> -_ ._ .._._.._._---_ . ..._ , .. ,..;�.�r
<br /> -- ., .4_i,..�•
<br /> • - .. .�� �vN r•.11YY4tr s�.y�'. . . ... ' . .. -. .�.. -._..._.._.__.....___�.._.
<br /> - r ' '- _I�:�P�'�`.=LfT:.:_-�_.
<br /> � _. ... . .....
<br /> i� ' _ '" .. . f. ' - ' � i� � - 5, - w��rsd�'. .
<br /> ,7 . . . . . . . . . .. •..
<br /> .. . , .1 '� . ..
<br /> ' - .. .. �i ' .. � .
<br /> � - , i� . .. .. . >..,r. '\.,_; .. .. �:..' . . �....�JB�` Ti�',�J=__' '
<br /> . ....,_ _...., . .._.. . . .. .. . ,. _
<br /> ,_ .. . .. .,. . _ . _ (p,.- -�- --_
<br /> ., I � ( ��r���(:';:I.�.aI`.-
<br /> „ � �nnhr6ekn`. Noti�� �f State '�'ax �len � ■ ��A�•1 l/ k—_rr., ,,�`�-
<br /> • I �tlepHrinienl ���"" ��;u:�''�1�,2�:.:-�
<br /> , � -•�ot rrranua ..,._ � - ------� =- ._ ...--�_
<br /> � TLRMI�1�'PYON pP SYATE 7/�K L.X�t� "--.- —
<br /> .. .�NDIVII]UAO. INCOML TAX a���.'---�°�--'
<br /> . YF Y�U YNQUI�i� ABOUT YptJR R-=.--
<br /> ACCaUN7� Et�FCR 'dQ �'H�SE NU�18�RS r __ __ ____
<br /> „ SUG. S�C. NQ• �062[v14d5 RO��RY M YOST �—
<br /> � N�t3R. TD.�LVT• N0. 1�36�?2C�1 __..__�
<br /> SPUUSE SaC. S�C. MO. 916 E OKLAHOHA =__�___
<br /> . YAXABLE YEAR 39E�7 GP1AN1� �SLAt�IA N� 6A$�`�
<br /> • LIEN Nt]• �9a2114�6 --_
<br /> L'lE�� P.�LE'.lSF ::�lo �L3??�3�9 ___
<br /> CAUN7Y HALL
<br /> AATE fl� NOTZCE 1�/15/94
<br /> , r �`���3Z �;-,:..
<br /> -� � INS�'RUMENT N0. •••/G •
<br /> P�IRSUANY TO THE REVEK E LA S �F THF STA3E AF NEBRASKAo NOTICE AS �rM
<br /> �° HGREBY GT�f�N SY TWE N�BRASKA UEPd►EiTMHN7 OF R�VENUE THA7 7HE -- -
<br /> STATc YAX LIEN NHECH HA5 e3��N ElULY FILED A6A�NST TH� ABqdE NAMED , �___
<br /> TAXPAYER F[lR INDIV3DUAL INCOME TAX�S IS T�FRMINATED. _
<br /> __.__...._. _._. __.. Y ucacav ��RrTFY 4l�147 THE NESRASKA D[PART�IENT �F RrVENUE 1�lAS COf1Pl.I�D �—`�-�
<br /> WITH 7HE RE1lENU� LAMS 0� THE STAZE OP NEBRASKA YN TIiE nETERMINJITION UF ��
<br /> 7HIS TERt�INAT ON. ""�""
<br /> ��`
<br /> � o fa��--qy -.�f�=
<br /> •• •�C�i• •s ���s�e • ��e�� •��������• ���• •���w�� •�����• �;'.-.^ _�
<br /> i�REPARER�S SIGNATURE Y7L� AAtE
<br /> . �) � . �Y /2-/�—4� :';�'�,.v
<br /> .l-.�. ...... .....o.. ......... .. .........�.... � _—
<br /> •. ..�:: � DATE . -." -
<br /> AUTHORIZ�D SIGNATUf;E YITLE ,�.'���
<br /> •��;ie+���r
<br /> - .YlI"�.!, -
<br /> " � FOR CUUNTY OFFICYAL�S USe � =•���
<br /> ` .,v..
<br /> ., � � I.
<br /> � �
<br /> • . � 1'�7 "'� � I '�^'.
<br /> � r C �" I
<br /> �
<br /> • c� c� �. N �
<br /> . � � � �� � c� -+ � �'-
<br /> h � � '� �- � � � .
<br /> `r � m :� "'' O -+ �^ •�' `n �
<br /> � •, �' c-� -t c� I � �
<br /> .) � N r� `n i
<br /> p -n ;. p.-+ c i
<br /> • � �; T ;� �
<br /> � ;�\` � � �� O �
<br /> .n 1 c � r � �
<br /> �, l� �,
<br /> i� ,C`�� N 1 ^7 p
<br /> .� p `�..� �
<br /> � �
<br /> �
<br /> �
<br /> � �,.�.,�,.. rn��.,rv-r�,w.,,.,n r�,�,v �
<br /> ._ ___ _� _.��.�
<br /> (�EQRASKADEPAFiTMENI UtHtvtlVUe-vmriomro�.m�mywpi65 ��v.�.,..-�.-.•...•,...v.� ••--• .. -----'------• _ '
<br /> ., ������� )•14S•f0 Rev 8•91'L
<br /> . Supene0�a 7•�a3•70 Rev 6tlp� .1 �
<br /> .r�
<br /> {
<br /> t�
<br /> „ . ,
<br />
|