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<br />~{ar'.,eYrr+,srMS+.~..w.~, .:;t ~a'e :e,--m ..,, ..3.«'_.za .".._.,,T'ytl>~+e-.art'~5'4s'it.+.zERM4"vk> <br /> INSTRUCTIONS <br />PURPOSE OF FORM, This form is w be used by the Nebraska <br />Department of Revenue for the purgox of notifying the appropriate <br />county authorities that a Notice of State Tax Lien is being filed <br />against the taxpayer indicated on this form. <br />The tax category number codes and the Nebraska tax programs they <br />; <br />' <br />~ <br />represent are listed below. <br />QI ... .......................... Sales Tax <br />02 ... .....................Retailers Use Tax <br />04 ... ................... Consumers Use Tax <br />10 ... ......................... Part-mutuel <br />21 ... ................Income Tax Withholding <br />22 ... ................. individual Income Tax <br />23 ... ..................Fiduciary Income Tax <br />24 ... ........Corporate Income and Franchix Tax <br />36 .... ...............Documentary Stamp Tax <br />'~ ... ......... idcehanicai Amusement vevice Tax <br />45 ... .......................Severance Tax <br />4b .... ........................ Estate Tax <br />47 .... .......................Cigazette Tax <br />67 .... .........................Litter Fee <br />fib .... .......................Lodging Tax <br />71 .... .........Interstate Motor Carriers Fuei Tax <br />82 .... .......Motor Vehicle Fuels [mportingDealer <br />85 .... ......................Aircraft Fuels <br />9l .... .......................Special Fuels <br />t,,,~ ~~.,. x~~ ~~,.~,~ , <br /> <br />~1 <br />v ~. <br />~ <br /> -~ ~ ~ \3 T3 ~ ~ 9/ <br />M <br />°G <br />' <br /> :'t ~' c;j ~. <br />~' <br />(c <br />~1~/ N <br />fi <br />`> <br />ry <br />~ -» <br />t1 <br />\1A~a <br />,., <br />~ ~~ i"" ' <br />~ C7 <br /> ~ t <br />i rt <br />T , S~ <br />~ ~.. <br />~.,., 9 ~ <br />r. ~ ~ <br /> " ~ ~ <br /> 4_ <br />tS! T <br /> _ ~ <br /> a <br /> <br />I , <br /> <br /> ~~ <br /> ~ <br />~~ Cs <br />~. ~ ~. <br /> <br />