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i - <br />Notice of State Tax Lien <br />rarke <br />~d~pet Nte~lt • w..e ineNUetlnne ee r.•.rr .id. <br />Lktn S•rlal Numbs/ Lien Type Dats Social SeeutlLy Number <br /> 0r19inel <br />2/09/341 ~ Renewal 9-2-82 527 08 4418 ~~ ~, <br />Nebraska I.D. No. County U•n Flletl With SPOYMY SocIN 9•curity ~; ~ 1 1 3 <br />4009436 Hdll o <br />~s NUmbar <br /> ~Co <br />nty Cler <br />BUSINESS NAME AND LOCATION ADDRESS <br />TAXPAYER NAMEAND MAILING <br />Business Name <br />Island Pools <br />strNt Adtlr•ss <br />247 South Uine <br />or Otner Malhng Address <br />1 tdoct Carlar - <br />Ctty State Zip Code City State ZI- <br />Grand Island, P!E 68801 Lake '.flood Colorado SUS <br />a code <br />This Notice of State Tax Lien is issued by Ure Nebraska Department of Revenue for unpaid-faxes=purwanr to the <br />revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalOes aotl=interest, which ace <br />shown below, are due from the taxpayer specified above and. remain unpaid aftu demand: Tlieae fazes conatitu~ <br />a lien in the county far real and personal property belonging to the taxpayer tx hereatteracquired: <br />Tex <br />Category <br />Numiter <br />Tax Period <br />ADeuasuirnortt <br />Amount of Tax <br />Penalty <br />Intaest <br />Addition <br />Aere~ieetent Dw-. <br /> <br />21 4-1-81 thru <br />6-30-81 <br />7-13-81 <br />99.42 <br />8.74 <br />108.16: <br /> <br /> <br /> <br /> <br /> <br /> <br />TOTAL I $ 108'.1.6- <br />1 Hereby certify that the Nebraska Department of Revenue has compllad with the Ievenue.laws of Me State of Nebraska to ttlt deter- <br />mination of the amount Shown to be tlLe, and the taxpayer has falletl tp pay the amount due after tlemantl. If tms tJOtiw of State Tax. <br />Lien is an extension of an ef}sctlve Ilan It Serves to Continue the priority of the state's intelszt In the a%Ktetl property of the ti^ileyer. <br />SI~11 ~_ "~ Special Anent 3-Z-84 <br />her Pr.P+r.r•2519na Title Date <br />TSpecial Agent 3-2-84" <br />Auttlorlietl 519natun Tltl• Oa(e <br />FOR COUNTY OFFICML'S USE <br />NEBRASKA DEPARTMENT OF REVENUE -White end Goldenrod Copies TAXPAYER -Pink Copy <br /> <br /> <br />COUNTY OFFICE - Cenery Copy <br />4-49x74 Rav. ~-el <br />Supersedes 4494-74 Rev. 5-BO <br />U <br /> <br />