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r ; Notice of State Tax Lien •Read instructions on reverse side Lien Serial Number L�p1 ietn Type Date Social Security Number —� Balance of., Number j g Original Penalty i Y Interasl Additions Ow 5105/760 C Renewal 5 -23 -85 262 -13 -3421 85- : 002512 Nebraska I.D. No. County Lion Filed with Spouse's Social Security 2.95 107 -01 -84 thru Number 4020324 Hall [ c untyr Clla Clark 10 -31 -84 401.34 120 .07 _t 31.40 BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS susiness Name Name —� Backer Construction 21 X12 -31 -84 Arnold Backer !23 40 20.10 street Address 511.41 Street or Other malting Address 2121 N. Webb Road, Suite 208 2121 N. Webb Road, Suite 208 City State _ _ zip code City State zip Code Grand Island, NE 68801 iGrand 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 taxes constitute a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. rex C Tax Period Date of I —� Balance of., Number j Amount of Tax Asses mint Penalty i Y Interasl Additions Ow 04 -01 -84 thru �� -� —� - 1 106-30-84 9 -13 -84 .00 .00 2.95 2.95 107 -01 -84 thru i 21 109-30-84 10 -31 -84 401.34 120 .07 _t 31.40 452.81 110 -01 -84 thru 21 X12 -31 -84 J-31-8.5 467.91 !23 40 20.10 511.41 0 thru 210�1 -85 14- 25 -85,1Q 4.,_29 --- - - - - -� 514.70 I 1 _ __ _� _ _ - -- — -- - - - - -- - — - -- - -- -- - - - - -- -TOTAL .. S 1,481.87 - -- I hereby certify trial the Nebraska oaparimont nl Raven— nas comohea wiln the revenue taws or ire State tit Nebraska In the dater nstrsatfon of the amount shown to Do aue, aria tn0 taxpayer nas fatleo 111 pay 1,110 armanrt our attar oornano. if Iris Notice of State Tax Lion it an aetension of an afflictive ii— it sar vas t,, cuntrn—, tar pri„rity of ins state's interest in Ins affecloo p—porjv of ine taxpayer. c�5 Revenue Agent 5 -23 -85 befer Rretmet Is atun .ride --Date IL - _SRecial__Ayent 5 -23 -85 Autnnrttfad •lure Title Dato FOR COUNTY OFFICIAL "S USE NEBRASKA DEPARTMENT ()F REVENUE While and 6otati-rel Gopiall IAXPAI'E ;R P-aCf.,iir (MuNTY()Ff'10E. C:enarvC,)py d. a9A,1,a loos, t -al Lupo rsadeb a- 4194 -'4 IYev. 5 40 W;