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<br />l~ebraSka <br />department <br />of revenue <br /> <br />Notice of State Tax Lien <br /> <br />NOTICE OF STATE TAX LILN <br />INDIVIDUAL INCOME TAX <br /> <br />8~ 100777i <br /> <br />I" <br /> <br />I <br /> <br />IF YOU INQUIRE ABOUT YOUR <br />ACCOUNT, REFER TU THESE NUMBERS <br /> <br />soc. SEC. NO. <br />NEBR. IDENT. NO. <br />SPOUSE soc. SEC. NO. <br />TAXABLE YEAR <br />LIHf NO. <br />COUNTY <br />DATE OF NOTICE <br /> <br />:'0:,543",63 <br />16591585 <br />~vb684801 <br />1984 <br />b6157044 <br />HALL <br />06/06/86 <br /> <br />RObERT R & bEITY L GREENl <br /> <br />2Ll5 !4 DIV ISlON <br />GRAND ISlANC <br /> <br />NE 6S801 <br /> <br />THIS NOTICE OF STATE TAX LIEN IS ISSL'ED 8Y fHE NEBRASKA DEPAk TME:NT OF <br />REVENUE FOR INDIVIDUAL INCOME TAX PURSUANT TO THE REVENUE LAWS OF THE <br />STATE OF NEBRASKA. NUTICE IS HEREBY GIVEN THAT INDIVIDUAL INCOME <br />TAXES INCLUDING PENALTIES AND INTFRiST, WHICH ARE SHOWN BELOW ARE DUE <br />FROM THE lAXPAYER SPECIFIED ABOVE AND k~HAIN UNPAID AFTER DEMANU. <br />THESE TAXES CONSTITUTe A LIEN IN THf CLU~TY FUR PROPERTY BELONGING TU <br />THE TAXPAYER OR HEREAFTER ACQUIRED. <br /> <br />AMUUNT OF TAX .. . . .. . . . .. . .. .. .. .. . .. . . . . . . . . 200.00 <br />PENALTY ~ . . . . . . . .. . . . . ~ . . . .. . . . . . . . . 50.00 <br />INTEREST ( COMPUTED TO 06/06/86 ) . . .. . . . . . .. .. .. . . . 31.99 <br />TOTAL AMOUNT DUE . . . .. . . . . . . . .. . . . . .. . . 281.99 <br /> <br />I HEREBY CERTIFY THAT THE Nb.lRASKA D~PAATMENT uF REVt.'NUl HAS COMPLlED <br />WITH THE REVl:NUE LAWS OF THi: STATE OF NEBRASKA IN THE DI::.TERMINATION OF <br />THE AMOUNT SHOWN TO 31::. UUE, AND THE TAXf-AYER HA5 FAIUD ra PAY THE: <br />AMOUNT DUE AFTER DEI4AND. IF THIS NLTICE OF STATE TAX LJEt-.4 IS AN <br />EXTENS ION UF AN EFFl:C 1I VE Lll:N IT HRVI:S TO CON llNUE Hil: PRIORlTY OF <br />THE STATE'S INTEREST IN THE AFFfCH:D PRUPERTY OF THI: TAXPAYlk. <br /> <br />...2J.~~...... <br /> <br />PREPARER'S SIGNATURE <br /> <br />...9 :#~k!~ <br />A~~ED SI~-:E <br /> <br />· f'.i,'J}l1111.f! ;d. .. . . . . . <br />TI TLE <br /> <br />. fl;.dl...~~.. <br />T~ <br /> <br />.<;..1.(.. ~cJ......... <br /> <br />DATE <br /> <br />.. i! :~'! ~ r.q:::.. <br />DATE <br /> <br />FuR COUNTY OFFICIAL'S USe <br /> <br />~...~ . <br /> <br />NEBRASKA DEPARTMENT OF REVENUE OFFICES <br /> <br />If you hive any questions regarding this notice. pleaie contact the Nebr.Ska Department Of Revenue. Box 94818. LinCOln. Nebraska 68509. or any of <br />the regional offices listed below. In NebraSka you may also dial toll free. your long di\lanc.e acc.ess number and 800-742-7474 for aSSistance. <br /> <br />LINCOLN - 14021471-2971 <br />OMAHA - 1402/ 554.2065 <br /> <br />GRAND ISLAND - 13081384-6829 <br />NORfOLK -14021371.1620 <br /> <br />NORTH PLA TTE - 13081 532-8250 <br />scons BLUFF - 13081 632.3637 <br /> <br />NEBRASKA DEPARTMENT OF REVENUE - WhIte and Canary Copies <br /> <br />TAXPAYER - Pink Copy <br /> <br />COUNTY -. Goldenrod CODV <br /> <br />79 <br /> <br />r <br /> <br />THE ATTACHED NOTICE(S) OF TAX LIEN (OR TERMINATION) IS (ARE) TO BE FILED ONLY WITH <br />THE REGISTER OF DEEDS. <br /> <br />THE DOCUMENT (S) IS (ARE) ~ TO BE FORWARDED TO THE COUNTY CLERIC <br /> <br />L <br /> <br />DISTRIBUTION OF <br />WHITE: <br /> <br />GOLDENROD: <br /> <br />COPIES: <br /> <br />TO BE VALIDATED BY THE REGISTER OF DEEDS <br />DEPARTMENT OF FL~ENUE. <br /> <br />TO BE KEPT BY TilE REGISTER OF DEEDS. <br /> <br />AND RETURNED TO THE <br /> <br />..J <br /> <br />BILLING IS TO BE ONCE PER NONTH AND TIIERE WILL BE:-10 PRE-PAYHENT OF FEES. <br />THANK YOU FOR YOUR COOPERATION. <br />