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IRS., <br />a <br />Notice of State Tax Lion <br />e Rud tnstnretlnns on revsras side <br />Number <br />Lien Type <br />oafs <br />Social Security Number <br />Penalty <br />Interest <br />C Original <br />Balance of <br />Assessment Due <br />Numbs r <br />Numbss <br />6 4 <br />F1 Renewal <br />5 -1 — <br />•• — <br />11 <br />5306 <br />$7. 105306 <br />NeWaaka I.D. No. <br />County <br />Lien Filed With <br />Spouu's Social Security <br />Register of Dead <br />Number <br />11 -30 -83 <br />-30 -84 <br />oA <br />2632802r <br />lial l <br />County Clerk <br />207 <br />OUSMIESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />BNstoesa: Name <br />Name <br />RI H!"ting <br />8 Plumbing, Ing, <br />J <br />s <br />Ittraet. Address <br />43.94 <br />Street or Diner Mailing Address <br />511 PjdyA <br />511 Padua <br />City <br />State Zip Code <br />City <br />State Zip Code <br />Ravenna, <br />NE 68869• <br />1 Ravenna <br />NE 68869 <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 remain unpaid after demand, These taxes constitute <br />alien in the county for real and personal property belonging to the taxpayer or hereafter acquired. <br />Tsx <br />Tax Period <br />Date of <br />Assessment <br />Amount of Tax <br />Penalty <br />Interest <br />Additions <br />Balance of <br />Assessment Due <br />Numbs r <br />Numbss <br />11-01-83 thru <br />01 <br />11 -30 -83 <br />-30 -84 <br />142.59 <br />8.66 <br />56.37 <br />207 <br />12 -01 -83 thru <br />01 <br />12 -31 -83 <br />-30 -84 <br />240.72 <br />43.94 <br />284.66 <br />1 -01 -84 thru <br />u <br />01 <br />1 -31 -84 <br />-06 -84 <br />314.86 <br />9.74 <br />53.75 <br />378.35 <br />2 -01 -84 thru <br />01 <br />2 -29 -84 <br />-12 -84 <br />230.55 <br />7.13 <br />36.79 <br />274.47 _ <br />3 -01 -84 thru <br />01 <br />3 -31 -84 <br />-19 -84 <br />184.69 <br />27.28 <br />211.97 <br />-01 -84 thru <br />01 <br />-30-84 <br />-19 -84 <br />1 222.89 <br />30.35 <br />260.13 _ <br />5 -01 -84 thru <br />01 <br />5 -02 -84 <br />-19 -84 <br />16.84 <br />2.09 <br />1 <br />1 <br />TOTAL <br />$ 1 <br />1 hereby certify that the Nebraska Department of Revenue has complied with the revenue laws of the State of Nebraska In the deter- <br />. miMtion of the amount sh wn to be due. and the taxpayer has failed to pay the amount due after demand. If this Notice of State Tax <br />Lien IS an ext SIO i of an a fective lien It serves to continue the priority of the state's Interest In the affected property of the taxpayer. <br />SIP Revenue Agent <br />INS. ep <br />Prarer' n re Title Da e <br />ri M a Special Agent ' 8 <br />Authorised SI Lure Title Dat <br />FOR COUNTY OFFICIAL'S USE <br />NEBRASKA DEPARTMENT OF REVENUE — White and Goldenrod Copies <br />L <br />TAXPAYER — Pink Copy <br />a <br />COUNTY OFFICE — Canary Copy <br />4.494.74 Rev. 7.81 <br />Supersedes 4.494.74 Rev. 5.00 <br />_.i <br />-i <br />