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tlebraska <br />r w:~e:t <br />r <br />Notice of State Tax Lien <br />• Read inrtrudtiom on reverse siM <br />Lien Serial Number Llpn Type Datp $ocfal Security Number <br /> Original <br />4/04/918 ^ Renewal 4- 3- 4 508-32-8102 A <br />~ <br />~ <br /> <br />Nebrafkd I.D. No. <br />County <br />Lien Filetl Wlth <br />$pouseh Social Security ~ ^ <br />~ <br />, <br />t~ ~~~ <br /> j Register of Deeds Number <br />4057058 Hall ~p cppnty clerk 507-42-4255 <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING AODRESB <br />BUSlnass Name Name <br />Glass Bar _ Jerry tJ. & Velma C,. Land <br />Street Atldress Street or Other Mailing Atldress <br />100? vilest North front Box 154 <br />City State Z+p Code ICity state clp coon <br />Grand Island, 'dE 68801 ~ Palmere `1F 6$~3fs4 <br />This Notice of Snte Tax Lien is issued by the Nebraska Department of Revenue far unpaid taxes pursuaRR to the <br />revenue Iatvs of the state of Nebraska. Notice is hereby given [hal taxes including penalfiea sM iiltereaE, udrichm <br />shown belovv, are due from the taxpayer specified above and remain unpaid after demand. Theae taxes corotitute <br />a lien in the county far real and personal property belonging to the taxpayer or hereafter acquired. <br />Tax <br />Cataaory <br />Numtw <br />Tax Period eau o} <br />Aasasarrrertt <br />Amount or Tax Partalty <br />Interest <br />Additions ttatattaa of - <br />AsrtaM-Ow <br /> 11-01-82 thru <br />Ol 1 _ ~- _ ~ <br /> 12-O1-82 thru <br />i <br />1 ~ r <br /> 01-O1-83 thru i ' <br /> X <br />~t _ _ a, = ~ ~ 168.05 <br /> - - nru <br />Ol ' 02-28-83 i 4-15-L'3 19fl.94 I_ 5.13 29.16 235.18 <br /> 03-01-83 thru ~ <br />O1 03-31-83 8-12-33 I96.~1 i 6,Oq 26 35 <br /> 04-O1-83 thru <br />01 04-30-83 fi-1?-83 193 51 ~ n9 4 A ~ <br /> 05-Ill-83 thru <br />Ol 05-31-Ss- ,:-12-83 ~i 53 5 0 ~ <br /> TOTAL I $1,210.60 <br /> I hereby cerl4fy [hat top Nebraska Department of Revenue has complied with the revenue laws Of the Stile pf NaDlasxa In txa datar~ <br /> minattpn o/ the amount sho wn to be due, and the tar payer has talletl to pay foe amount dw after tlemintl. I f tnie NoNba bf StiM Tax <br />r Llan is an aitMS(on of an a fiectiva Ilan ~t serves to continue the priority of the sta[s'f inlereet m the affa<ted propNty Or Ma taxrNyaf. <br />~~~ ' 2.evenue Agent <br />~ 4-13-84 <br />~~~~ ep 51 Title Data <br /> Soecial Agent <br />-- 4-13-84 <br /> AutborlZW 51 re~ Tttb Oils <br />- ~ FOR COUNTY OFFICIAL'S USE <br />NEBRASKA DEPARTMENT OF REVENUE -White and Goldenrod Copl@s TAXPAYER - Pmk Cppy <br />COUNTY OFFICE -Canary Copy <br />4-494-74 Rev. )-al <br />Supersedes 4-49q-3q Rev- 5-a0 <br />u <br /> <br /> <br />~~ <br /> <br />