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<br />l~nebraSka <br />, department <br />. of revenue <br /> <br />Notice of State Tax Lien <br /> <br />88- 101045 <br /> <br />I <br /> <br />NUTICE OF STATE TAX lIEN <br />INDI V IDLJA L 1 NCOME L!\ X <br /> <br />I <br /> <br />IF YOU INQUIRE ABOUT YOUR <br />ACCOUNT, REFER TO THESE NUt.HiERS <br /> <br />soc. SEC. NO. <br />NE B R . 10 E NT. NO. <br />SPOUSE soc. SEC. Nu. <br />TAXABLE YEAR <br />LIEN NO. <br />COUNTY <br />DATE OF NOTICE <br /> <br />50~74':5701 <br />17377870 <br />50<.\660& 11 <br />1985 <br />8626L057 <br />HALL <br />0'1/19/86 <br /> <br />KFr80N A f. SHAWNA KEMMf.k <br /> <br />3543 FARM::' TEAD RO <br />GRANO ISLAND <br /> <br />NE 68801 <br /> <br />THIS NOTICE OF STATE TAX LIEN IS ISSuEL; B,( THE NtBRASKA. DEPAi<TMl::NT Uf <br />REVENUE FOR INDIVIDUAL INCOME TAX PURSUANT fO TH~ R~VlNUl LAWS OF THl <br />STATE OF NEBRASKA. NOTICE IS HEREBY GIVEN THAT INDIVIDUAL INCUME <br />TAXES INCLUDING PENALTIES ANO INTEREST, WHICH ARE SHUWN dELUW ARE DUE <br />FROM THE TAXPAYER SPECIFIED ABOVE AND R~MAI~ UNPAI~ AF1FR DEMAND. <br />THESE TAXE S CONSTITUTE A LIEN IN THE ClJJNTY FOR. pxoPUnY~::LUNGING HJ <br />THE TAXPAYtR OR HEREAFltR ACQUIkcD. <br /> <br />AMOUNT OF TAX .. . . .. . .. . . . .. . . . .. . . .. .. . . Lv4.il <br />PENALTY . . . . .. . . .. .. . . . . . . . . . . . . . . . . . 10.90 <br />INTEREST ( COMPUTED TO 09/19/36 ) .. . . . .. . . . .. . . . 12.<Jj <br />TOTAL A MOU NT DUE . . . . . . . . .. . . . . . . . . . . .. . 228.UL <br /> <br />I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMeNT OF KEVENUE HAS COMPLIElJ <br />WITH THE REVENUE LAWS uF THE STATE GF NEBRASKA iN THE DETERHINATION OF <br />THE AMOUNT SHOWN TO BE QUE, AND THI.; TAXPAYER rlAS FAILeD TO PP,Y THE <br />AMOUNT DUE AFTER DEMANU. IF HilS NOTICE OF STATt TAX LIEN l~ AN <br />EXTENSION OF AN EFFECTIVE LIEN IT SERVES TO CONTINUE' THE PRluRlTY Uf- <br />THE STATE'S INTEREST IN THE AFFECTEO PRu?ERTY OF THE TAXPAYER. <br /> <br />..M.~...... <br /> <br />PREPARER'S SIGNATURE <br /> <br /> <br />..,.Q~.. .... <br />AUTHOR~ZE~ SIGNAT E <br /> <br />.~~,ti. .d)!1f....... <br />TI TLE <br /> <br />.~ :~.-P.ti... ... <br /> <br />OP.1E <br /> <br /> <br />.. C;",;; i}..~... <br />Tl~~. <br /> <br />:;l~?~d~' <br />...............0 <br /> <br />DATE <br /> <br />FOR COUNTY OFFICIAL'S USE <br /> <br />C' <br /> <br />NEBRASKA DEPARTMENT OF REVENUE OFFICES <br /> <br />If you have any questions regarding this notice, please contact the Nebraska 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 distance access number and 800-742-7474 for assistance. <br /> <br />LINCOLN - (4021 471,2971 <br />OMAHA - (402) 554.2065 <br /> <br />GRAND ISLAND - (3081 384-6829 <br />NORFOLK - (4021371.1620 <br /> <br />NORTH PLATTE - (3081532.8250 <br />SCOTTS BLUFF - (3081 632.3637 <br /> <br />NEBRASKA DEPARTMENT OF REVENUE - White and Canary Copies <br /> <br />TAXPAYER - P,nk Copy <br /> <br />COUNTY - Goldenrod Copy <br /> <br />._-~.~-. <br /> <br />r'- <br /> <br />THE ATTACHED NOTICE (5) OF TAX LIEN (OR TERMINATION) IS (ARE) TO BE FILED ONLY <br />THE REGISTER OF DEEDS. <br /> <br />THE DOCUMENT(S) IS (ARE) !!2! TO BE FORWARDED TO THE COUNTY CLERK. <br /> <br />DISTRIBUTION OF COPIES: <br /> <br />WITH <br /> <br />L <br /> <br />WHITE: <br /> <br />TO BE VALIDATED BY THE REGISTER OF DEEDS AND RETURNED TO THE <br />DEPARTMENT OF REV~t!~_ _===-.=-=.=-~--:--:---, <br /> <br />TO BE KEPT BY T1{i-~~GISTER OF DEl:DS; <br />-----.- .-.- --- <br /> <br />ONCE PER MONTH AND THERE WILL BE ~O PRE PAY' <br />- .-lENT OF FEES. <br /> <br />..J <br /> <br />GOLDENROD: <br />BILLING IS TO BE <br /> <br />r' <br />,..... <br /> <br />THliliK YOU FOR YOUR COOPERATION. <br />