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is <br />9 <br />.. <br />. .~. . _ <br />Notice of State Tax Lien <br />' adta <br />.:s ..........t • Rand imtruatiom on rsww aMa <br />LNn arlaf Numbn Uan 7yp! Oats' - SDCiJI SKUrlty Number <br /> Oriq;nal <br />~:, {"-` 3 ~- ~~~ Q Renewal 1-24-83 -0 .4"y, <br />~ ~ ~ <br />tt Nlibflska L.Q. No. County LienFitao with Sponsor's Social Security Q~'~" <br />^~ t-' <br /> ~ Raglstar of Dleo Number <br />(/t1 <br />_ ~ ZI,w36pj;~;t~ tt <br />Hdl1 ~ COUnfY Ctlrk <br />BUSINESS NRME AND LOCATYVN Ai7DIt CitD <br />Buelna# Name Name <br />fation & Roofing Inc. A & N Insulation & Roofing Inc. <br />StrNt RtldrNS Street or ()that Mailing Atldrass <br />1 1 P.O. Sox 974 <br />Ctty Stara Z1p-Cade- City Stara Zip Cotle <br />NE 68843 Grand Island, NE 68801 <br />This Notice of State Tax Lien is sued by the Nebraska Department of Revenue for unpaid taxes pursuant to the <br />revenue laws of the state of Nebraska. Notice is hereby giren that taxes inchuiing penalties and interest, which are <br />shown below, are due from the taxpayer spe<ti4ied above and remain unpaid after demand. These taxes constitute <br />a ben in the county far real and personal property belonging to the taxpayer m hereafter acquired. <br />Tax <br />Cataaory <br />Nutnbr <br />Tax Pariod Data of <br />Asaa+:nunt ~ <br />Amount of Tax + Penalty intarast <br />Additiorn Ba4np of <br />Assas9ttent Dua <br /> 03-O1-80 thru j <br /> 10-07-80 thru <br /> I i <br /> ~-- <br /> I j <br />f ~ ~ ~ <br /> <br />TQTAL ~ $ 5(14.61 <br />I troraby Cert{ty chat the NlDraaka departman[ of Revanue has cpm pllatl with the revenue law's of the Stara Ot Nebrdika In the tle[er- <br />miMtfOn of the amount snpwn t0 Da dug, end tha taxpayer nay tauetl :o pay tna amount dug a'.ier demarw. if this Notice of State Tax <br />Llan Iz an axt! on of an eftscttve lien it carves t0 Continua the prlorftY of [he state`s Interest In the afTlctetl property of Me taxpayer. <br />~gA ~'~ special Agent i-24-83 <br />here preparp~ 51 tit,. date <br />S~eciai Agent 1-24-83 <br />Aut+mtlzetl Sign! re T1tle date <br />FOR COUNTY OFFICIAL'S USE <br />NEBRASKA t1EPARTMENT OF REVENUE - Ylpefp attd fiofdanrod Captor TAXPAYER -Pink Copy <br />COUNTY OFFICE -Canary Copy <br />4-aga•7s Rav. 7-81 <br />Sutrorsetles a-496-)a Rw. 5-ap <br />u <br />~ .__1 <br /> <br />