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1 <br />P . lh /Sra*.!B <br />cep alt <br />Notice of State Tax Lien <br />e Read instructions on reverse side <br />LfCf SO-W NO—Do' <br />I Li! Type <br />I Data <br />,Social security Nt/rfltter <br />1 _- - <br />2 05 434 <br />DrI4lnai <br />�R•new•I <br />03 -03 -82 <br />506 -46 -2692 <br />A..a__ <br />{](jII 1,01192 <br />_ <br />NebratkA I.D. Np. County <br />Lien Filed With <br />Spouse4 Social Security <br />`XReyister of COeti <br />Number <br />3221603 <br />Hall <br />❑ County Clerk <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Nita - <br />Name - <br />Richard G. McMichael <br />-Stf*et Atlstress <br />Street or Other Milling Address _ <br />4215 Arizona Avenue <br />City <br />State <br />Zip Code <br />City State Zip Code <br />Grand Island NE 68801 <br />This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the <br />revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are <br />shown below. are due from the taxpayer specified above and rerna. mtI if after demand. These taxes constitute <br />a fien in the county for real and personal property belonging to the taxpayer or hereafter acquired <br />Cssepry ! Tau Period OAs"oemmit Amount of T" _PWnrty InWeSt Additions 1 Asmamemot Due <br />afeeofier <br />01 -01-82 t <br />01 01 -31 -82 1 04-07 -8t 333.75 10.32 8.19 It 352.26 <br />02 -01-82 th j <br />tit 02 -28-82 1 04 -07 -81 41.18 5.00 0.52 # 46.70 <br />TOTAL I S 398.96 <br />' 1 hereby cattily that the Nebresi a Department of RevMu* i•as c- ipiied attn the reveoex Laws of the State of N bntska in the oe4 - <br />nrnatiCn Of the amoWft Shown to be due. ant the :—payer has fated to pay the atount cut after demand. It this Notice of state Tau <br />Uen LV48111%ixtension, of #n effO en t ssaarvH to continue the prtorfty of the state$ interest in the affected property of the tamilsaylr_ <br />.^-� 9x,"`"1 Revame Agent 3 - "Cf <br />14 si4haturn - .Title - EMU <br />It 1 tanager ,3- el- F7 <br />AuMorifto Sisnatuto - Title - Date <br />FOR COUNTY OFFICIALS USE <br />NEBRASKA DEPARTMENT OF REVENUE - White and Goldenrod COPOS TAXPAYER - Palk Copy COUNTY OFFICE - Catvv Copy <br />ererry atrnas <br />Y <br />Td€ AYA7 isR'f10E137 of TAX LIEN Cris zEtMNA =zcar'7 IS Qisxiie•:i TO BE r �..z= <br />THE REGISTER OF DEEDS. <br />THE DOCUMENT(S) IS ( ARE) NOT TO BE FORWARDED TO THE COUNTY CLERK. <br />DISTRIBUTION OF COPIES: <br />WHITE: TO BE VALIDATED BY THE REGISTER OF DEEDS AND RETURNED TO THE <br />DEPARTME!fT OF REVENUE. <br />GOLDENROD: TO BE KEPT BY THE REGISTER OF DEEDS. <br />BILLING IS TO BE ONCE PER MONTH AND THERE WILL BE NO PREPAYMENT OF FEES. <br />THANK YOU FOR YOUR COOPERATION. <br />a <br />