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r <br />a <br />tma,t <br />ravtttue <br />Notice of State Tax Lien <br />e Reed instructions on revere side <br />Lien Serial Number <br />Lien Type <br />Original <br />Date <br />Social Security Number <br />i Penalty <br />3/03/193 <br />[2 Renewal <br />3 -2 -83 <br />- -9 <br />M�002495 <br />Nebraska W. No. <br />County <br />Lien Riled with <br />Spouse's Social Security <br />Ase�ent Due <br />[I Register of Dead <br />Number <br />2751380 <br />HALL— <br />County Clark <br />SMINESS NAME AND LOCATION ADDRESS <br />X8-31 -82 <br />—ruth <br />TAXPAYER NAME AND MAILING ADDRESS <br />Businees Name <br />1 <br />Name <br />1157 34 <br />i QA^ <br />& LgUnge <br />VarliLa G <br />.lnhngtnn <br />Street Address; <br />_ <br />Street or other Mailing Address <br />City <br />State <br />Zip Code <br />CISy <br />State Zip Code <br />Ca <br />185.32 <br />JO-01-82 thru <br />NE 68801 <br />This Notice of Stare 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 />Tic <br />Tait Pa <br />Period <br />^ q of <br />De <br />Amount of Tex <br />i Penalty <br />Interest <br />Additions <br />N t <br />A>a�mant <br />Ase�ent Due <br />�- <br />01 <br />X8-31 -82 <br />—ruth <br />11-30-82 <br />158.06 <br />1 <br />1157 34 <br />P9-01-82 <br />01 <br />-30-82 <br />111-30-82 <br />177.04 <br />' • 28 <br />185.32 <br />JO-01-82 thru <br />__$ �. <br />! <br />01 <br />0 -31 -82 <br />1 -31 -83 <br />' 220.95 _x.83 _y 7.80 <br />5.58 <br />-01 -82 thru <br />i <br />01 <br />1- 111-31-83 <br />2-01-82 <br />1 __5.4SZ___ - - -_ _ 4 24_____. _- <br />- $1�Z4 -- -- - <br />01 <br />thru <br />2 -31 -82 �1 -31 -83 <br />j <br />_L74.68 _ 1 2.Oj_ _ . ' <br />�iT -- <br />IRP 09 <br />-83 thru 1 <br />01 1-31-8 13-2-82 _ 1 AA3..1.3_e�__ <br />TOTAL <br />S T 10� -FjL_ <br />i herepy certify trial ire Nebrasxa Department or nevenne has compowl with the revenue taws at the State at Nebraska in the dotef- <br />mMatfon of Me amount snown to Do tlue, ants the taxpayer has fallen to pay the amount flue after demand, 0 this Notice of State Tax <br />i ^n is an extension of an effitCiive lien it Serves to continue the priority of the state's Interest In the affected property of the taxpayer. <br />e jr <br />Revenue <br />enarer's s Wr• rule Date <br />Special -Agent - -- 5 -22 -85 <br />Authrstiaed 5l tux* ltle -'"Date <br />FOR COUNTY OFFICIAL'S USE <br />NE ASKA DEPARTMENT CIF REVENUE -- White and Goldenrod C opics T- AXPAYER - Pink Copy <br />M <br />COUNTY OFFICE Canary Copy <br />a 94- Y4 teev l a <br />„uVrsede® a.. 4941" Rev. 9 so <br />Y <br />