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a <br />Notice of State Tax Lien <br />fteprasJca <br />tfimltt <br />_ IF,- r avanua *Read instructions on reverse side <br />Lien Serial Number Lion Type Date - Social Security Number <br />C1 Original <br />0/051544 [X Renewal 105/21/80 507 -50 -9244 ��,ry <br />Nebraska I.D. No. County � g� Lien Filed With Spouse's Social Security V 2 <br />3550680 Hall & Register of Deeds Number <br />. 6:+7 County Clerk <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADORE <br />- ftsineu Name <br />CrtrC <br />q Street Address <br />,011 <br />city <br />state <br />Zip Cade <br />or Other Mailing <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 />Mown below, are due from the taxpayer specified above and remain unpaid after demand. Thew taxes constitute <br />a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. <br />4 <br />Tax <br />I lax Paled <br />Nf <br />Oat® of <br />A ent <br />Amount of Tax Penalty <br />— I <br />I Interest <br />Additions <br />Balance of <br />Assessment Due <br />i 04/01/79 thr110 <br />-21 ( <br />7 <br />148.46 7.42 <br />7.40 <br />163.28 <br />07/01/79 thr <br />�LQ <br />21 (09/90!79 <br />1 <br />187.51 9 38 <br />I <br />I 61 <br />47 <br />TOTAL <br />miniiion of in® amOUOt shown to D® du ®', antl Me tax paYert nag t failed tot PaY In- amocntrtIuala ter de rmeand'ti this Notice o1 StareeTax <br />Le@n is an extend) of ar. effective lien It serves to continue the priority of the state's interest n the affected propeLrty of the taxpayer. <br />SW <br />glavenue Agent <br />is $i anattlbre L_r <br />to <br />_ er <br />A arts Signature Till. <br />Date �'��� <br />i FOR COUNYV OFFBCIAL S USE <br />NER"ASKA DEPANTMEN "r of Fit vEN,PE sYfttte and GaltlanrrxP (:opiat ' AXPAYEFi p,hh (:,py tai iN9 v )F F It E ana, __ <br />u cc >tty <br />.1 .saa.;.t ta.,. ' w i <br />,e,s,aee+a�r a aua.:'.t 14— xn <br />V <br />