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1 <br />lNBTRUCTIONS <br />PURPOSE OF FORM. This form is to be used by the Nebraska <br />Department of Revenue for the purpose of noflfying the appropriate <br />county authorities that a Notiee of State Tax Lien is being fEed <br />against the taxgayer indicated on this fomt. <br />~y The tax category number codes and the Nebraska tax programs they <br />~~ J iJ ~.A ~" ' ,repesent are listed below. <br />OI .............................SalesTax <br />02 ........................Retailers Use Tax <br />04 ...................... Consumers Use Tax <br />10 ............................ Parrmutuel <br />21 ...................Income Tax Withholding <br />22 ....................Individual Income Tax <br />23 .....................Fiduciary Income Tax <br />24 ...........Corporate Income and Franchise Tax <br />36 ...................Documentary Stamp Tax <br />44 ............Mechanical Amusement Device Tax <br />45 ..........................Severance Tax <br />46 ............................ Estate Tax <br />47 ...........................Cigarette Tax <br />67 .............................Litter Fee <br />68 ...........................LodgingTax <br />71 .............Interstate Motor Carriers Fuel Tax <br />81 ...........Motor Vehicle Fuels Importing Dealer <br />85 ..........................Aircraft Fuels <br />91 ...........................Special Fuels <br />a~ ~ ~.~ <br />W i <br />. ~~ - T _ --i M m <br />•Aa r-n a m yy (gyp <br />v ~ _ Q ^~' G7 G~ ~ Q~ <br />C V :..: I ... ~ ~ <br />~ ~ ~ ,<~ N ~ s s o ~ <br />'" I v <br />w <br />o ~ I ~ <br />`'` r'V ~ ~- p ~ ~ <br />O~ (I) I ~ + <br />0 <br />~~ <br /> <br /> <br /> <br />