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neeraska Notice of State Tax Lien tment of revenue NOTICE OF STATE TAX LIEN INDIVIDUAL INCOME TAX IF YOU INQUIRE ABOUT YOM 004897 ACCOUNT. REFER TO THESE NUMBERS SOC. SE-C• NO. 5 078 0 1009 GARY L S DENISE M BORUCH NEAR• IDENT• NO. 20580371 SPONGE SOC• SEC. NO. 506849144 1515 M 17TH TAXJULE YEAR 1984 GRAND ISLAND NE 68601 LIM ND. 85256063 C"TY HALL DATE OF NOTICE 09113/55 'MIS NOTICE OF STATE TAX LIEN IS ISSUED BY THE NEBRASKA DEPARTMENT OF R"AMiE FOR INDIVIDUAL INCOME TAX PURSUANT TO THE REVENUE LAWS OF THE STATE OF NEBRASKA. NOTICE IS HEREBY GIVEN THAT INDIVIDUAL INCOME TAXES INCLUDING PENALTIES AND INTEREST* WHICH ARE SM" BELOW ARE DUE FROM THE TAXPAYER SPECIFIED ABOVE AND REMAIN UNPAID AFTER DEMAND. TH 3E TAXES CONSTITUTE A LIEN IN THE COUNTY FOR PROPERTY BELONGING TO THE TAXPAYER OR HEREAFTER ACQUIRED. ANOINT OF TAX 311.37 PmLTY . . a 48.25 1NTMST ICOMPUTED TO 09/13/85) . . . . . . . . . . . . . 18003 TOTAL AMOUNT DUE w . . • . • . • . • . . • • • • . • . • 377.65 I MMOV CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPLIED 1111N THE REVENUE LAWS OF THE STATE OF NEBRASKA IN THE DETERMINATION OF THE A/I"T SHOWN TO BE DUE* AND THE TAXPAYER HAS FAILED TO PAY THE ANMW DUE AFTER DEMAND• IF THIS NOTICE OF STATE TAX LIEN IS AN EXTMION OF AN EFFECTIVE LIEN IT SERVES TO CONTINUE THE PRIORITY OF THE S"OS INIERES. IN THE AFFECTED PROPERTY OF THE TAXPAYER. UARER$S SI ATURE TITLE j DATE ' C—o 3.� i In Alt ZED SIGNATURE TIT ' DATE FOR COUNTY OFFICIAL *S USE NEBRASKA DEPARTMENT OF REVENUE OFFICES .,� s c :: t ,s rus u•. .,.. , a r. �,�. .vr:•'aesa _,. ••g r� tee .1 ., p5 +�S �,, a <. �. �A ter atF v ar i a .. ,, _ a a -r a.._ e. .� r .- lip )41. s a r LINCOLN -- !4027 411.2971 GRAND ISLAND 13081 384!6829 OMAHA - 4011 554.2055 NOHF OLK 1402! 371 1620 NEBRASKA DEaARTPr+LNT F.)6 it v rr i .. ..f C3 1 re . C -., TAI P.: NORTH PLATTE ;3081 532.8250 SVOTTS BLUFF - ;30816323637 tas , m I