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l~nebraSka department of revenue 88~ 100561 Notice of S,tate Tax Lien I NOTICE OF STATE TAX LIEN INDIVIDUAL. INCOME TAX IF YOU INQUIRE ABOUT YOUR ACCOUNT. REFER TO THESE NUMBERS soc. SEC. NO. NEBR. IDENT. NO. SPQUSE soc. SEC. NO. TAXABLE YEAR LIE..q NO. COUNTY DATE OF NoTICE DATE OF ASSESSMENT DONALD 0 & SALLY A BEASON 503266556 27906205 POBOX 1886 GRMiD ISLAND NE 68802 1976 87226305 HALL 08/14/87 07/13/87 THIS NOTICE OF STATE TAX LIEN IS ISSUED BY THE NEBRASKA OEPARTHb~T OF REVENUE FOR INDIVIDUAL INCOME TAX PURSUANT TO THE REVENUE LAWS OF THE STATE OF NEBRASKA. NOTICE IS HEREBY GIVEN THAT INDIVIDUAL INCOHE TAXES INt'-WING PENALTIES AND INTEREST, WHICH ARE SHOWN BELOW ARE DUE FROR THE TAXPAYER SPECIFIED ABOVE AND REMAIN UNPAID AFTER DEMAND. THESE TAXES CONSTITUTE A LIEN IN THE tOUNTY FOR PROPERTY BELONGING TO THE TAXPAYER OR HEREAFTER ACQUIRED. AMOUNT OF TA}C . . . . . . . . . . . . . . . . . . . . . . . 293.27 PENALTY . . . . . . . . . . . . . . . . . . . . . . . . . . 14.66 I INTEREST ( COMPUTED TO 08/141'87) . . . . . . . . . . . . . . 425.16 TOTAL AMOUNT DUE . . . . . . . . . . . . . . . . . . . . . 733.69 I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED VITH THE REVENUE LAWS OF THE STATE OF NEBRASKA IN THE DETERMINATION OF THE AMOUNT SHOWN TO BE DJE. AND THE TAXPAYER HAS FAILED TO PAY THE AMOUNT DUE AFTER DEMAND. IF THIS NOTICE OF STATE TAX LIEN IS AN EXTEltSION Of AN EFFECTIVE LIEN IT SERVES TO CONTINUE ntE PRIORITY OF THE STATE IS INTEREST IN THE AFFECTED PROPERTY OF THE TAXPA'fER. .5l~.~....... PREPARERIS SIGNATURE .~ ft? - -Lf f2 tlf::. iA~O~TURE .~.J9~~....... TITLE . L~!-9:.~~...... DATE ~.~.. . I. -.2J.:~?:..... DATE FOR COUNTY OFFICIAL'S USE .-- .n;, '.' " -, NEBRASKA DEPARTMENT OF REVENUE OFFICES if you have any Questions. regarding this notic.e. please contact the Nebrliska Department of Revenue, Box 94818, LinCOln. Nebraska 68509. 0' ar the regional offices listed below. In Nebraska you may alSo dial toil fr~. your lon9 distance aetess number and 800.742.7414 for assistance. LINCOLN - 14021 411.2971 OMAHA - 14021 554-2065 GRAND ISLAND - 13081 384-6829 NORFOLK - 14021 371.1620 NORTH PLATTE - 13081532.8; SCOTTS BLUFF - 13081 632-3f NEBRASKA DEPARTMENT OF REVENUE - WhIte and Canary CopIes TAXPAYER - Pink Copy .. COUNTY -- GOldenrod Cop L THE ATTACHED NOTICE(S) OF TAX LIEN (OR TERMINATION) IS (ARE) TO BE FILED ONLY WITH THE REGISTER OF DEEDS. THE DOCUMENT(S) IS (ARE) ~ TO BE FORWARDED TO THE COUNTY CLERIC DISTRIBUTION OF COPIES: WHITE: TO BE VALIDATED BY THE REGISTER OF DEEDS AND RETUffi1ED TO THE DEPARTMENT OF REVENUE. GOLDENROD: TO BE KEPT BY TIlE REGISTER OF DEEDS. BILLING IS TO BE ONCE PER MONTH AND THERE WILL BE NO PRE-PAYHENT OF FEES, THANK YOU FOR YOUR COOPERATION. I ; ~. ,.--- ..J (.