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IteDraska <br />ttttp8rttrtent <br />pf revenue <br />~.. <br /> <br />Notice of State Tax Lien <br />• Read instructions on reverse side <br />Liars Sarlal-Number Llen Typa Date Social Security Number <br /> [~ Original <br /> <br />3/2/111 <br />~Renewa~ <br />2-23-83 <br />472-48-5479 p <br />8~-""tJaQ <br />00 <br />Ndotaska l.D_ No,_ County Lien Filed with SDOUSe's Social Security (~ <br /> Register of Oeeds Number <br />4254422 Hall [~cpY~tyclerk <br />BUSINESS NAME ANU LVL:A I IVrv Auvn tAJ <br />Busirsess Name Name <br />Courtes Court Motel Dewa ne R Mickl <br />- Street Address Street or Otner Mailing Address <br />2301 West 2nd 36 Test 104th Street <br />- CItY Sidle ZIR Code City State 2iP <br />Grand Island tdE 68801 B-foomin4ton M'i( 551 <br />This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the <br />revenue haws 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 />alien in the county for real and personal property belonging to the taxpayer or hereafter aegilired. <br />TeX <br />Category <br />Tax Period Date of <br />Assessment <br />Amount of Tax ~ <br />Penalty Interest <br />Additiom Balance of <br />Assessment Dua <br />Number <br /> 08-O1-82 thru <br />O1 OS-31-82 11-28-82 727.50 5.00 ~ 7.14 139.64 <br /> 09-01-82 thru ~ <br /> R ~ <br /> 11-01-82 thru i <br /> - - ~ 12-3L- a I n <br /> 12-O1-82 thru <br /> <br />- - <br />- - ' ~~ <br />--j - na_~n <br /> i <br /> <br /> TOTAL ~ 5 553.!11 <br /> 1 hereby certify ihdt the Nebraska Department of Revenue ha s complietl with ihfl revenue laws of the State Of Nebraska in the tleter- <br /> minatian of the <br />amount snows to be Oue, antl the taxpayer nas `ailatt to pay tna amount tlue after tlemantl. If tots No[ice Of State Tax <br /> / <br />lien (s an @ G ~iOn of an 0fte ve lion [ S z to tontin Me tDe priority of the Stata'S mierast in the aff@Cted propetty Of the tdxpayer. <br />sign ~ ~~ ~ 1 Revenue F,geni 7_-23-83 <br />h is Si _ Titter Date <br />ie J _ <br /> Special Agent 2-23-83 <br /> Authprl2eQ gna 0 Tina O3te <br />FOR COUNTY OFFICIALS USE <br />NE$RASKA QEPAATMENT OF REVENUE -White and Goldenrod Copies TAXPAYER - Pmk Copy COUNTY OFFICE -Canary Copy <br />a-493-7a Rev, 7-B3 <br />Supersetles 3-493-1d Rev, 5-a0 <br /> <br /> <br />