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. .~Ib,alke a,lmenl , grrevenuI Notice of State Tax Lien 88- 10~L~OO NOTICE OF STATE TAX LIEN INDIVIDUAL INCOME TAX IF YOU INQUIRE ABOUT YOUR ACCOUNT, REFER TO THESE NUMBERS: 508-94-1134 29037239 RHETT A, WAGNER SOC. SEC. NO. NEBR. IDENT. NO. SPOUSE SOC. SEC. NO. TA:CABLE YEAR LIEN NO. COUNTY DATE OF NOTICE DATE OF ASSESSMENT 1985 86276101 HALL 10/03/86 603 NORTH KENNEDY STREET GRAND ISLAND, NE 6~801 THIS NOTICE OF STATE TAX LIEN IS ISSUED BY THE NEBRASKA DEPARTMENT OF REVENUE FOR INDIVIDUAL INCOME TAX PURSUANT TO THE REVENUE LAWS OF THE STATE OF NEBRASKA. NOTICE IS HEREBY GIVEN THAT INDIVIDUAL INCOME TAXES INCLUDING PENALTIES AND INTEREST, WHICH ARE SHOWN BELOW, ARE DUE FROM THE TAXPAYER SPECIFIED ABOVE AND REMAIN UNPAID AFTER DEMAND. THESE TAXES CONSTITUTE A LIEN IN THE COUNTY FOR PROPERTY BELONGING TO THE TAXPAYER OR HEREAFTER ACQUIRED. AMOUNT OF TAX . . . . PENALTY . . . . . . . INTEREST (COMPUTED TO TOTAL AMOUNT DUE "1(),,/O'3/'B~ $ 156.00 7.80 10.23 174.03 I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED WITH THE REVENUE LAWS OF THE STATE OF NEBRASKA IN THE DETERMINATION OF THE AMOUNT SHOWN TO BE DUE, AND THE TAXPAYER HAS FAILED TO PAY THE AMOUNT DUE AFTER DEMAND. IF THIS NOTICE OF STATE TAX LIEN IS AN EXTENSION OF AN EFFECTIVE LIEN IT SERVES TO CONTINUE THE PRIORITY OF THE STATE'S INTEREST IN THE AFFECTED PROPERTY OF THE TAXPAYER. . 2tJ ~. . . . . . . . . . . . PREPARER'S SIGNATURE ~~.~~..9~. TITlE' , .. is' - J j.' W- "'............. DATE &~.., ~.f) rJ-Q - '. TITLE r~ .~:/I.-.~K:.. . DATE FOR COUNTY OFFICIAL'S USE NI.RASKA DEPARTMENT OF REVENUE OFFICES II yoU haUl any QUIIllanl ragardlna Ihll nallcI, 01.... canlaCllh. NID'lIka Oloarlm.nl 01 R.vlnul, Box aUll, Lincoln, Nlbralka 615011, or an>, of Inl realanal alllclIlIlled bilow, In NID'lIka you mlY Ilia dial loll I'N, your lana dlll.ncI ICCI" number Ind 100-742-7474 fOrl"llllncI, LINCOLN -101021471-2171 OMAHA - 101021 5114-20111 ORAND ISLAND - (3011311-117211 NORFOLK - (4021371-11120 NORTH PLATTE - 13081532-8250 SCOTTI BLUFF - 13081 832-1200 I NlilflAIKA DEPAflTMENT OF REVENUE - Whltl Ind Can.rv COplH TAXPAYER - Pink COpy COUNTY - Gold.nrod Copy 7,145-711 Rov 11-87 'l'HE A'l'TACHED NOTICE(S) OF TAX LIEN (OR TERMINATION) IS (ARE) TO BE FILED ONLY WITH Tn! REGISTER OF DEEDS. THE DOCUMENT (S) IS (ARE) NOT TO BE: FORWARbE:D 'i'O 'fal;: COUNTY CLERIC DISTRIBUTION OF COPIES: WHITE: 'i'O BE VALIDATED BY THE REGISTER OF DEEDS AND RETURNED TO TilE - DEPARTMENT OP' REVENUE. GOLDENROD: TO BE KEPT BY THE REGISTER OF DEEDS. BILLING IS TO BE ONCE PER MONTH AND THERE WILL DE NO PRE-PAYMEN'1' OF "'1-:1,$. THANK YOU FOIl YOUR COOPEM'fION.