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84000178
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Last modified
11/18/2008 2:34:10 PM
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11/18/2008 2:34:05 PM
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84000178
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<br /> I~oti~e of Sta#e Tax Lien <br />-nebraska - - <br />department <br />Ot revenue <br />• Read-instruMions an revsrsi side - <br />J... <br />~ BUST <br />t <br />Sfiei <br />csty <br />BVSYNE9SNAME ANI) LV4'ATIC)N AO1]t1EJ~ TA7SPAYEW NAMt ANt1 MAiLfNG AppHtDJ 1 <br />ie - Name - - - _ ~ -! <br />[sl-and Welding_ bJi1 _ <br />ss Street dr OtnerMeilin9 Adtlrets - - - - - <br />1 <br />- State Zip Cptle CIYY State - - ZIp Code <br />d 688 1 5 r 68872 <br />This Notice of State Tat Lien is issued by the Nebraska [>epartment ofAevenue for. unpaid taxes ptrtsaant to-the <br />revenue laws-of the state of Nebraska.-Notice is hereby giverrihat taxes including-penattiesand~interest;wtiich are - <br />shown below, are due from the taxpayer specified above and remain unpaid'after'demand: These taxes coasGtute <br />alien in the county for real and personal property belonging to the taxpayer or hereafttir acquired. <br />Tax. <br />Category. <br />Number - <br />Ta>-Period Date of <br />Assessment <br />Amount of Tax <br />Penalty <br />Interest <br />Additions Balance of - <br />pssasonaM'Oue- -. <br /> <br />O1 07-O1-82 thru <br />04-30-82 <br />12-27-83 <br />X1.69 <br />5.00 <br />6.94 <br />53:68: - <br /> <br /> <br /> <br /> i <br /> <br /> <br />' TOTAL I ~ 53.68 <br />- - 1 hefeby certify [oat the Nebraska Department of Revenue nas complied -with the revenue I>ws Ot the Stet¢ of Nebraska In the deter- <br />' minalion of the amount shown [o D¢ due, antl the taxpayer has felled to pay the amount due after demand- If [hit Notice Of State TaX <br />Uen is an exfansion of an effective lien i/~Snrves to con nnue the priority of the [fate's interest in the attected property of the taxpayer. <br />sign 4tQiryn.rrrt ~ c~`t-~a1 Pevenue Apent 1-11-84 <br />~`~~ ~ Preparer's ¢ - i? % - Title Data <br />W- ~ Special Aqent 1-11-84 <br />r Autporizetl Si lure ~: Tltb Date <br />FOR COUNTY OFFICIAL'S USE <br />NEBRASKA DEPARTMENT OFREVENUE - Wfiite grid Gotdeorad Copies TAXPAYER -Pink Copy <br /> <br />LFen Serial Number Llen Type Date Soctai Secur7ty Number- - <br /> t7r19inai <br />4' Ol 459' '~ Renewal _ {Qj ffii <br /> <br />Nebraska I.D. No. <br />County - <br />-Cleo Filed Wtth <br />SpouseY Soc[al Security '""~1.1 ~ ~ <br />fir"} <br /> ` R1 R¢9ise¢r or Deed Number <br />3064f>F4 Hall -~ County Clerk <br />COUNTY OFFICE -Canary Copy <br />4-494-74 Rev. 7.01 <br />Supersetles 4-494-74 Rev. 5.80 <br />U <br /> <br /> <br />
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