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1■ Notice of State Tax Lien e Read instructions on reverse side LIME Serial. Number Lien Type Date Social Security Number l Penalty interest Additions [3 Original 07 -01 -85 thru In the affected property of the taxpayer. 6/07/756 ❑ Renewal 7 -15 -86 507 -74 -3826 86--- 10 3954 Nebraska -:. J.D. : No. County Lien Filed With Spouse's Social Security 4789199 Hall Z Register of Deeds Number 7 -9, -86 _ County Clerk 01 BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS Business Name 1 25.00 Name The Syntax Company, Inc. I Janet R. Walker Street Address -22 -86 Street or Other Malting Address 3235 S. Locust Street i 1197.30 2712 West Stolley Park Road - -'City' State zip Code City State zip Code Grand Island, NE 68801 -, Grand Island, NE 68801 This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are shown below, are due from the taxpayer specified above and remain unpaid after demand. These tares constitute a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. Tax Category Number Tax Period Date of Assessment Amount of Tax l Penalty interest Additions Balanceance of Assessment Due i 07 -01 -85 thru In the affected property of the taxpayer. sign- �Lien 7e lJ; /(G� %t Revenue Agent 01 07 -31 -85 -23 -85 24.24 5.00 1.32 30.56 08 -01 -85 thru 7 -9, -86 _ _ AtithorIZed Si Lure 01 08 -15 -85 -13 -86 FOR COUNTY OFFICIAL'S USE 1 25.00 1 25.00 21 04 -01 -85 thru 06 -30 -85 -22 -86 1453.14 72.66 i 1197.30 - 1723.10 1 — 107 -01 -85 thru . I2 21 08 -15 -85 6 -13 -86 i 727.00 781.75 73.06 981.81 I - - -- _ � _ _ i I TOTAL s 2,760.47 0 im EJ CO i nereoy certify that the Nebraska Department of Revenue has complied with the revenue taws of the State or Nebraska in the deter- mination of the amount shown to be due, and the taxpayer has failed to pay the amount due after demand. If this Notice of State Tax is an ex nston of an e(fec, lien i[ stirves to continue the priority of the state's interest In the affected property of the taxpayer. sign- �Lien 7e lJ; /(G� %t Revenue Agent 7 -9 -86 n pa ef 's ature Title Date Special Agent 7 -9, -86 _ _ AtithorIZed Si Lure Title _ _ Date FOR COUNTY OFFICIAL'S USE 116 '86 AM I2 d lt•t ,ra =,2 1 ��ir�6 • � f Cleirk NEBRASKA DEPARTMENT OF REVENUE — White and Goldenrod Copies TAXPAYER Pink Copy COUNTY OFFICE — Canary Copy - 4- 49474 Rev. 7.81 - Suoersetles 4- 49474 Rsv. 5 -BO 0 im EJ CO