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<br />1It;fi,ebtaSka <br />deparllnenl <br />of revenue <br /> <br />Lien Serial Number <br /> <br />Notice of State Tax Lien <br /> <br />188_ <br /> <br />101967 <br /> <br />8/04/724 <br /> <br />Lien Typo <br />00 O"glnal <br /> <br />o Renewal <br /> <br />Counly <br /> <br />Dalo <br /> <br />. Read instructions on revorso siuo <br />Social securlly Number <br /> <br />!"'" <br /> <br />- 1 5- 88 <br /> <br /> <br />? <br /> <br />5245028 <br /> <br />Lien Flied With Spouse's Social Socurlly <br />rn Reglsler of Doeds Number <br />Ha 11 0 County Clerk <br /> <br />BUSINESS NAME AND LOCATION ADDRESS <br /> <br />TAXPAYER NAME AND MAILING ADDRESS <br /> <br />Nebraska 1.0. No. <br /> <br />Business Name <br />Va1dezs Place <br /> <br />Name <br /> <br />Street AddreSS <br />386 N. Walnut <br /> <br />I nacio M. Valdez <br />slroet or Other Mailing Address <br /> <br />City <br />Grand Island, <br /> <br />State <br /> <br />Zip Code <br /> <br />622 ~~est 11 th <br />City <br />Grand Island <br /> <br />State <br /> <br />Zip Code <br /> <br />NE <br /> <br />68801 <br /> <br />NE <br /> <br />68801 <br /> <br />This Notir<~ of State Tax lien is issued by the Nebraska Department of Revenue for unpaid taxes pursnant to the <br />revenue laws of the slate of Nebraska. Notice is hereby given that taxes including penalties and interest, which are <br />shown below. are due from the taxpayer specified abo\'e and remain unpaid after demand. These taxes constitute <br />a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. <br /> <br />I Tax Date of Balance of ! <br />Category Tax Period Assessment Amount of Tax Penalty Interest Additions A:ssessment Due <br />Number <br /> 03-01-87 thru <br />01 07-31-87 603.87 20 37 69 67 693.86 <br /> 04-01-87 thru <br />21 06-30-87 2- 11-88 63.63 15 91 f),11 R5.R7 <br /> I <br /> - <br />'. <br /> TOTAL S 779 _ 71 <br />, <br /> <br /> <br />i heleby certify that Ule 9raSka Department of Revenue has complied wllh Ille revonue Ilws 01 tile Slate of Nebraska In the deter. <br />mlnal;on of mount Shown he <lue. an<l the taxpayer has failed to pay tho amount due alter demand. " this Notice of State Tax <br />Lien 15 an nsloll of an effect e lien it rv~S to ~ntlnue the priority 01 Ihe slale's Intere51 in the affected property 01 the taxpayer. <br /> <br /> <br />. ~ ,v-' 0--4 Taxpayprc:; Sprv; Cp SI)Pr.; ill i st Ll-lll-R8 <br />Title Date <br /> <br />Revenue Agent Supervisor <br />Titlo <br /> <br />4- 15-88 <br /> <br />Date <br /> <br />FOR COUNTY OfFICIAL'S USE <br /> <br />,; <br /> <br />NEBRASKA DEPARTMENT OF REVENUE - White and Goldenrod Copies <br /> <br />TAXPAYER - Pink Copy <br /> <br />COUNTY OFFICE - Canary Copy <br /> <br />4,494-14 Rev. 1,81 <br />supetse<les 4.494,74 Re,'. 5-80 <br /> <br />THE ATTACHED NOTICE(S) OF TAX LIEN (OR TERMINATION) IS (ARE) TO BE FILED ONLY <br />'mE REGISTER OF DEEDS. WITH <br /> <br />~ <br /> <br />THE IXX;UMENT{S) IS (ARE) NOT TO BE FORWARDED TO THE COUNTY CLERIC <br /> <br />DISTRIBUTION OF COPIES: <br /> <br />WHITE: TO BE VALIDATED BY THE REGISTER OF DEEDS AND RETURNED TO THE <br />DEPARTMENT OF REVENUE. <br />GOLDENROD: TO BE KEPT BY THE REGISTER OF DEEDS. <br /> <br />BILLING IS TO BE ONCE PER ~IONTH AND 'rHERE WILL I3E NO PRE-PAYHEN'r OF FEES. <br /> <br />THANK YOU FOR YOUR COOPERA'l'ION. <br /> <br />L <br />