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�rrrebraska - <br />ednpanment <br />o! revenue <br />Notice of State Tax lien <br />•Read inatruetinns on revarae ail. <br />..iart Sari:: t:wtiber '' 'an Type <br />Data <br />Soeiat Security Numoer <br />Amount of Tax Penalty Interest <br />7/03/439 0 Renewal <br />3 -5 -87 <br />507 -74 -1787 <br />87-- 101251 <br />- - - - <br />Nebraska I.O. No. 1 County <br />Lien Filed With <br />Spouse's Social Security <br />Register of Deed <br />Number <br />- - <br />4857690 Hall <br />(] county Clerk <br />1176.19 <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />- <br />Name - - - <br />Robert & Jessie Leibert <br />- - <br />1-30-86 <br />Street Address <br />- <br />Street or Other Mailing Address - <br />410 S. Webb <br />01 -86 thru <br />City State <br />Zip Code <br />City - State Zip Cade <br />Grand Island, NE <br />68801 <br />- <br />This Notice of State Tax Lien is issued by the Nebraska Depart -ent 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 remain unpaid after demand. These taxes constitute <br />a hen in the county for real and personal property belonging to the taxpayer or hereafter acquired. <br />Tax <br />Catowy <br />N <br />Tax Period <br />i <br />Dab of <br />Assessment <br />Amount of Tax Penalty Interest <br />Additions <br />- Raimme of <br />asap op. <br />10 -01-85 thru <br />i <br />21 <br />- <br />- - <br />L 4 47 <br />1176.19 <br />01 -01 -86 thru <br />s <br />- - <br />1-30-86 <br />78 41 141.00 <br />537.69 <br />01 -86 thru <br />i <br />- <br />79.53 <br />1 1082.21 <br />07 -01 -86 thru <br />71 <br />09-an-Afi <br />10-31-86 <br />- 68.92 <br />1578.32 <br />110 <br />-01 -86 thru <br />- - <br />1-11-86 <br />7.25 8.17 <br />660.51 <br />f <br />� <br />F <br />TOTAL <br />S 5.034.92 <br />__ _.. .._. — ornptsM wit, the reveM1pe lass of the state of reaorastra in the o~ <br />minitiofl of Lhe a M snow to be due. and the taxpayea has failed to Puy the amount due after demand. if this Npt{C! of S9b Tyr <br />UM if an exb I of in ef1K a Iirerr it swygs to Lontln the ss-ity OL tna state's interest in trial affected property of the taayiyR_ <br />f <br />nt.YeIItle Agent 3-5-$7 <br />a <br />Ilk SMiai Agent 3-5-87 <br />AuinorLxad Signal Ti2N [}ab <br />FOR COUNTY OFFiCtALM USE <br />NEORASKA DEPARTMENT OF REVENUE — White and Goidanrod Cozies TAXPAYER — Pink Copy _ CC USI. Y OFFICE — Canary Color <br />A NOTICES) OF TAX LIEN (OR TION) IS (AM) TO BE FILED ONLY WITH <br />`T88 RBGISTER OF DEMS. <br />THE <br />DOCUMENT(S) IS (ARE) NOT TO BE FORWARDED TO THE COUNTY CLERK. <br />°DISTRIBUTION OF COPIES: <br />WHITE: TO BE VALIDATED BY THE REGISTER OF DEEDS AND RETURNED TO THE <br />DEPARTK;NT OF REVENUE. <br />GOLDENROD I TO BE KEPT BY THE REGISTER OF DEEDS. <br />BILLING IS TO B$ ONCE PER MONTH AND THERE WILL BE NO PRE— PAYFIENT OF FENS. <br />THANK YOU FOR YOUR COOPERATION. <br />t <br />a <br />