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lrib'."'. dto.r1m.n1 of"lVInu. Netlce of State Tax Lien 88- 104611 NOTICE OF STATE TAX LIEN INDIVIDUAL INCOME TAX l IF YOU INQUIRE ABOUT YOUR ACCOUNT, REFER TO THESE NUMBERS soc. SEC. NO. NEBR. IDENT. NO. SPOUSE SOC. SEC. NO. TAXABLE YEAR LIEN NO. COUNTY DATE OF NOTICE DATE OF ASSESSMENT 508080563 27861228 476746056 1987 88211859 HALL 07/29/88 05/11/88 GORDON & JENNIFER KOSMICKI 235 SPINE GRAND ISLAND NE 68801 <1J~ 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 . PENAL TV . . . . INTEREST (COMPUTED TO 07/29/881 TOTAL AMOUNT DUE I HEREBY CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED WITH THE REVENUE LAWS OF THE STATl OF NE8RA~A IN THE OETERMINATION OF THE AMOUNT SltOWN TD 8E DUE, AND THE TAXPAYER HAS FAILEO TO PAY THE AMOUNT DUE AFTER DEMAND. IF THIS NOTICE OF STATE TAX LIEN IS AN EXTENSION OF AN EFFECTIVE LIEN I'r SERVES TO CONTINUE THE: PRIORITY OF THE STATE'S INTEREST IN THE AFFECTED PROPERTY OF THE TAXPAYER. ..;)A,1t~....... PR~t::'ERas SIGNATURE ~~;; 485.00 24.25 19.53 528.78 z~.~. ~fI:=.- nn.1"or" ~ /J...J- d _ .:. TITLE YfH~ f.-.I!.1.~. ...... DATE . ~-I.9.; K.t..... DATE FOR COUNTY OFFICIAL'S USE I NEBRASKA DEPARTMENT OF REVENUE OFFICES Ir you hay. .ny QUillIan, rig' raIn; this notlCl, plUM contlct tn, Nebra.ka Departmlnt at Rn.nI.... Box 514111, Uncoln, NlbtlSka 158~DIiI, or any J' thl r'~lIon.1 otflcl.ll.t.cs bllow. In Nlbralk.l you may allo dl.ll toll "", your Ion; alll.nee .call numb.r Ind 800.7'2.'4'4 fo, .IIIUlnCI. LINCOLN -14021471-21171 ORAND ISLAND -1308) 381.5725 NORTH PLATTE _ (3081 832-8280 OMAHA - 11021 S1II-2085 NORFOLK -1402'371.1520 SCOTT8 BLUFF _ 1_' 532.1200 I NEBRASKA DEPARTMENT OF REVENUE - White and Clin.tv Copl.. TAXPAVER - PInk Copy COUNTY _ Goldenrod Copy ___._.-0._.___._______ . .. TIlE ATTACHED NOTICE(S) OF TAX I.IEN (OR TERMINATION) IS (ARE) TO BE FILED ONLY WITH THE REGISTER OF DEEDS. THE DOCUMENT(S) 15 (ARE) NOT TO BE FORWARDED TO TIlE COUNTY CI>ERK. DISTRIBUTION OF WHITE: COPIES: TO BE VALIDATED BY TilE REGISTER OF DEEDS DEPARTMENT OF REVENUE. TO BE KEPT BY THE REGISTER OF DEEDS. AND RETURNED TO THE GOLDENROD: BILLING IS TO BE ONCE PER MONTI! AND TI!ERE WILL BE NO rRE-rIlYMENT <.1F' FFFS. THIINY- YOU FOR YOUR COOPERATION.