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Notice of State Tax Lien ?5-- 004663 <br />e Riled instructions on favor" side <br />: Lien SWNt Number <br />lien TYPO <br />Date <br />social Security Number <br />Penalty <br />Intaratt <br />— <br />f] Original <br />Arewment Due <br />21 <br />- S thru <br />30 -85 <br />5/09/306 <br />[] Renewal <br />9 -24 -85 <br />8.23 <br />�_ <br />417.96 <br />NlaWaske LD. No. <br />County <br />Lien Filed With <br />Spouse's Social <br />Security <br />K) rlkaed <br />umber <br />4997344 <br />m <br />i <br />OUSINEfE NAME AND'LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />.ou$Mm -Name <br />_ <br />Nam* <br />804ugeste Ltd., Pelican Bay <br />Pelican Bay <br />Street <br />street Address <br />2610 South Locust <br />2610 South Locust <br />_ <br />City State Zip Code <br />state State — Zip Code <br />Grand Island, NE 68801 _ <br />Grand Island, NE 68801____ <br />This Notice of State Tax Lien f4 issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the <br />revemrc laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are <br />shown below, are due from the taxpayer specified above and remain unpaid after demand. These taxes constitute <br />a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. <br />Tex <br />CMobw <br />Tact Period <br />AgMRitent <br />Amount of Tax <br />Penalty <br />Intaratt <br />— <br />Additions <br />Arewment Due <br />21 <br />- S thru <br />30 -85 <br />7 -31 -85 <br />390.22 <br />i 19.51 <br />4 <br />8.23 <br />�_ <br />417.96 <br />Authprlaad.5lg tar• <br />T'itto <br />Dat< <br />i <br />-- - --� <br />-- -- —__— ��_--- ------ - - - - -- TOTAL — <br />S 417_96— <br />1 haeeby [N that the Nebraska Department Of Revenue has complied wnfr the revenue taws Of the State of Nebraska in the deter. <br />miMtlOn oft Uont to own lU Da dPO, and the taxpayer <br />hat ta{IM to pay the amount due altar demand. If this Notice of State FAA <br />Lien if aA a ion of all of tive lien t Ivet tU f.Uf ll lue <br />lne Priority of the Vale.$ inlerest in <br />the affected Property Of 11'. taxpayer. <br />C�'x�� _y&r1w_99wL— <br />— 2¢-85 <br />hirePr <br />- <br />a Lure r �""1 ) <br />-�- •r�~ - -- <br />Title <br />— _- <br />Date - <br />9 -24 -85 <br />Authprlaad.5lg tar• <br />T'itto <br />Dat< <br />FOR COUNTY OFFICIAL'S USE <br />kt#RASKA DEPARTMENT OF REVENUE -. White and Goldenrod Copies <br />TAXPAYER Pink Copy <br />COUNTY OFFICE - Canary Copy <br />4.494 ] 4 lieu. /.a t <br />.�uNNrterdat 4.494.14 Rev. S e) <br />u <br />a <br />_I <br />