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~~nebraska <br />repprtment <br />i. n <br /> <br />Notice of State Tax Lien <br />• Rsad insiructiom pn rewrsa tittr <br />Lien Seriet Number Lien T`lPe Date SOCIai Security Numbe[ <br /> ~} Ori9inal - - <br />3/08/874 ~ Ranewdl 8-9-83 505-54-3879 <br /> <br />Nebraa{ra I.D. -NO. <br />County <br />~ <br />Ltan Pilap With <br />Spdnse's Social SecurlTy ~y q A <br />- y(ii ~('j (~ ~Q./ - <br />VT <br />~j w <br />- <br />2780ff62 Hami 1 ton ~ Ra9dter of Deett <br />~ CpuntY Clark Number tJ <br />BUSINESS NAME.AND LDCATiON ADDRESS T7UtYATtn-rtratne.wrvu.nwe~tr•u._auvncan ~- <br />nuainesa mama "am° Marna C] ark Porath d/b!a <br />Mi~haPl'c FTDraI R gift ' <br />- St+eef Atldrass Street or Other Manin4-AdGress. - <br />11~ Wpc Ord t :lyd <br />City State Zip Code Lity States - ~Ztp Code <br />This Notice of State Tax Lien is issued by the Nebraska DeparDnent of 12evenve for unpaid taxes pursuant to the <br />revenue taws of the state of Nebraska, Notice is hereby given that taxes including pevatties-and interest; which are.: - - <br />shown below, are due from the taxpayer specified above and remain unpaid after demand. These-taxes constitute <br />a lien in the county far real and personal property belonging to the taxpayer a hereafter acquired. <br />Tax <br />Category <br />Number Date of <br />Tax Period Assesiznart <br />Ampum of Tax <br />~ Panatri <br />Interest - <br />Additions Balanaa of: - <br />Assexattant Due ~- <br /> <br />i 11-O1-82 thru <br />- 0- I1-~ - 3 ~ <br />17 D5 <br />8 00 <br />I 20 5i <br />2 6 4 <br /> 12-01-82 thru <br />~ ` <br />~ <br /> - 1- 1-31-83 305.86 9.46 22 29 7 1 <br /> i03-O1-H3 thru j ~ ~ <br />1 - 1- 3 r8-1-83 238.51 ~ 3.92 it 18 308.6T <br /> X04-01-83 thru <br />Oi ~04-30-83 ;$-1-83 i 259.25 __. ._ _4,01 __ I <br />~~ 7.56 ~ 274 82 <br /> 05-OT-83 t~rui ~ ` <br />O1 X05-31-83 48-1-83 I 325.Q9 10.08 5.63 341.70 <br /> 06-01=83 thrul <br />O1 0-$3 ~8-1-83 ~ <br />?06-3 205 7 ~~ b 35 ~ 1.18 ~ 13 <br /> ~ <br />k _---? --_-~ _ ~ <br /> ToTRL ~ ~ 1,722.20 <br />_ i Oereby Certity that the Nebraska DaOar;m ant Ot Revenue has c mptietl with the rawnua laws Ot the State Ot Nebraska in the tle[er- <br /> indtlOn of the a t shown to ba pug, and <br />0 the tea payer nds tallep [e pay the amount due attar demand. If knii Notice of State Tax <br /> LFen is do e <br />tartzl n <br />n/ an efiet~rv <br />~, tt sarr es k0 continue the priority of fhe stat0'z Interest in th e effected property of the tdzpaYer. <br />SIQ11 ~ <br />/ <br />- ~d7~'y'~-L~YZ~P revenue Agent 1-23-84 <br />fiere bparer <br />rra Title Ddte <br /> ~ <br />~ _~-~ ~ ~~ <br />~ Suecial r;4ent 1-23-84 <br /> Au NOtiZetl SL tore <br />° ': iris Date <br />NEflR:RSKA DEPARTMENT OF REV ENUE -White and-Goldenrod Copies TAXPAYEfl -Pink Copy <br /> <br />COUNTY OFFICE -Canary Copy <br />4-49474 Rav. 7-81 <br />Suparsatles 4-494.74 Rav, S-80 <br /> <br />t.... <br />