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r <br />Notice of State <br />rtabraskis <br />�pgrintent <br />ot'revonue a Read instructions on r <br />Lion Serial Number <br />I Lien Type <br />Date <br />Social Security Number <br />Interest <br />Additions <br />Balance of 1 <br />Astessrnani Due <br />01 <br />101 -01 -84 thru <br />101 -31 -84 <br />3 -13 -84 <br />85--- <br />5/031359 <br />® Renewal <br />3 -19 -85 <br />505 -64 -1482 <br />00130,5 <br />Nebraska I.D. No. <br />County <br />Lion Filed Witn <br />Spouse's Social <br />Security <br />� <br />i <br />X Register of Deeds <br />Number <br />— - <br />I <br />4396634 <br />Hal l <br />® County Clerk <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />Business Name <br />y <br />Name <br />Leisure Distribution d /b <br />/a The Recroom Shoppe <br />Roger A. Gade <br />Street Address <br />Street or other Mailing Address <br />2228 N. Webb Rd. <br />Rural Route 1, Box 231 <br />City State <br />Zip Code <br />City State Zip Code <br />Grand Island,_ _ NE <br />68801 <br />Grand Island, NE 68801 <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 />a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. <br />Tu <br />Category <br />Number <br />I <br />Tax Period <br />Data of <br />Assessment <br />Amount of Tax Penalty <br />Interest <br />Additions <br />Balance of 1 <br />Astessrnani Due <br />01 <br />101 -01 -84 thru <br />101 -31 -84 <br />3 -13 -84 <br />00 37.73 <br />7.96 <br />45.69 <br />01 <br />iO3 -01 -84 thru <br />iO3 -31 -84 <br />14 -25 -84 <br />1 689.40 21.32 <br />86.73 <br />797.45 <br />� <br />i <br />j <br />;- <br />— - <br />I <br />1 <br />y <br />i <br />TOTAL <br />s 843.14 <br />I hereby Cattily that trio Nebraska Department of Revenue has compiled with the revenue laws of the State of Nebrasta in the dater. <br />"nation or the amount shown to be due, and the taxpayer has <br />failed !o pay the amount due after demand. If this Notice of State Tax <br />Lien Is an extension of an effective lien it serves to continue the <br />priority of the state's interest In trio affected property of the taxpayer. <br />sign L <br />Revenue Accent 3 -19 -85 <br />here epato's ur• — - -.�. <br />Title Date <br />__ S�ec.ial A eg nt 3 -19 -85 <br />T � -- <br />Authortred Sign re <br />Title Date <br />F-- -. _ - - -_ <br />FOR COUNTY OFFICIAL'S USE <br />NEBRASKA D €PARTMENTnF NEWNUE white and Gotdentod C.opte® TAXPAYER Pnk Copy COUN Ty Orr ICf Canafv gritty <br />a a tiara Rev, p -i <br />nq?ers ""S 4 A" ,'.t Inev, h no <br />