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rliffi <br />0 <br />Notice of State Tax Lien <br />e Read instructions on reveres side <br />Link Serial Number <br />Lien Type <br />® <br />Date <br />Sodal Security Number <br />Additions <br />$"y Diif2i9s <br />3/10/108 <br />Renewal <br />10 -28 -83 <br />505 -50 -9386 <br />Nebraska t,D. No, <br />County <br />i-on Filed With <br />Ls7t <br />Spouse's social security <br />76.12 <br />a Register of Deed <br />Number <br />5.56 <br />11,,__ <br />Hall all <br />County Clark <br />_12.48 <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />sut{rteri Name <br />95,R <br />Name <br />5.96 <br />Safari Bar 8 Lounge <br />106.78 <br />Yerlie G. Johnston <br />Street AiNlress <br />Street or Other Mailing Address <br />106 East 2nd Street <br />7 -22 -$ 63,$2---- <br />803 Shady Bend Road <br />3.68 <br />City State <br />Zip Code <br />City <br />state Zip Code <br />Grand Island, NE <br />68801 <br />Grand Island, <br />NE 68801 <br />This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the <br />Menge laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are <br />shown below, are due from the taxpayer specified above and remain unpaid after demand. Thege taxes constitute <br />a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. <br />E <br />Nt E Tact Period <br />Asse"Ment Amount of Tax <br />Penalty <br />interest <br />Additions <br />Ann n eew Dw <br />-01 -83 thru <br />O1 n2-28-83 <br />4-8-8 65,40 65 40 <br />5.12 <br />5.60 <br />76.12 <br />03 -01 -83 thru <br />- - <br />f 11 -83 179, 80 <br />5.56 <br />197.84 <br />f04 -01 -83 thru <br />_12.48 <br />95,R <br />5 00 <br />5.96 <br />106.78 <br />thru <br />Q1 X05 -31 -83 <br />7 -22 -$ 63,$2---- <br />5.00 <br />3.68 <br />72.50 <br />b6 -01 -83 thru <br />_. - - - -- <br />-- - - -_1 <br />_ <br />150.91 <br />5.00 <br />50 <br />161.41 <br />7 -01 -83 thru ' <br />- - <br />- 169.$3 ' <br />-0- <br />1 9 <br />17 -01 -83 thru <br />j <br />01 <br />9-25-83 - - _196.5____ �15.�4� <br />14.47 <br />t�si <br />TOTAL <br />0 03.11 <br />I heresy Certlfy that trio Nobrasxa Department of Revenue has complied with the r—nue taws of the State or Nebraska in the dolor. <br />urination Of the amount shown to be due, and the taxpayer ftas lailed to pay the amount due alter demand. It this Notice of State Tax <br />Lien is or, extension of an effective Ilan it serves to continue the priority of tale state's interall in the affected uropally of the taxpayer. <br />• ` Z' <br />l __�.___ Re Agent 5 -22 -85 <br />��S epafaf sera � tiPO Dale <br />• Autriortrad naturo — °— - -_— - �CialA gqt 5 -22-85 <br />T414 Date <br />FOR COUNTY OFFICIAL'S USE <br />?499RA3KA DEPARTMENT OF REVENUE - White end Goldenrod Copies TAXPAYER - Pink Copy COUNT "Y OFFICE. Canary Copy <br />da y478 Rev, r,at <br />.;nttarsenas 44H4,ra idav, 5 -aO <br />am <br />9 <br />