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MR Notice of State Tax Lien •Read instructions an reverse side ,qWvooy revenue Date of Assessment 5-2.3-86 Amount of Tax Penalty Interest Additions 20.20 33. M---- - LM-2 Lion serial Number Lien f I-s—, Oaty ilk 0'iymai i 6/07/754 , —R a-,, -a .4-1 16-25-86 —` Nebraska I.D. No. county I--- 11—Pled " Reg Bier -1 Dead! 4894995 Hall BUSINESS NAME AND LOCATION ADDRESS Business Name Q—nay. N ',hakp 479-58-9395 sp.s S.ak Security TAXPAYER Name Ronald K. Hill- 86-103811 OtIner tA.jhn9 ACC11.15 Street Address 1 11006 R Plaza #4 411 W. 9th & Hiwav 11 io I City slat. Zip State Wood River, NE 68883 Omaha, NE 68137 nt to the This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant are revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, shown below, are due from the taxpayer specified above and remain unpaid after demand. Thew taxes constitute a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. Tax Catellory Tax Period Number 04-01-85 thru ni 104-30 -85 !05-01-85 thru j 01 Date of Assessment 5-2.3-86 Amount of Tax Penalty Interest Additions 20.20 33. M---- - LM-2 Balance of u Assessment Due 178.20 176.62 06-01-85 thru i 01 06-In-gs 175.09 07-01-85 thru 01 ;07-31-85 1 25-flO, TOTAL 650.94 ------ - ------ sate f NeWaska �r, Me 1�1- i neieby certify tnat ',"C NeWdSkA DaPd?t-Cf1t �f Pe I"'E' "le N�tice ,, State d— J--d be j—, —o I t--P�ycl nat;on Of t"e amount in—'. t' Lien is an o 1 f..t Cd P! Del t Y 01 I I e 3 Pa Y�l - sign R g -v pr-u g Aser �I hef a Special Agent ,Aulnorqed 3i9nPFW -- ----------- FOR C&UNTY OFFICIAL USE NESF4ASKADEPARTMF.,NTI�,F:REVEN'LJE T ;, -,;1A Y F, R P7'. f,oj'y COUNTY OFFICE Canary Copy 4 494-;' '4:v ' "I 4 4.-4 >4 R � il 80