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<br /> <br />"",.f~':l'P"~~'N"'*~'''~i:'~<--'''''':7'''+_,~;,:~~,~--'t''"'''''.~1J>'.-' <br /> <br />INSTRUCTIONS <br /> <br />PURfIOSE OF FORM. This form is to be used by the Nebraska <br />Department of Revenue for. the purpose of netifjdng the'appropriate <br />=untjf authorities that a Notice of State Tax lien is being med <br />against the taxpayer indicated on this form. <br /> <br />1"he" tax category number codes lIUd the Nebraska tax programs they <br />repreSent are listed below. <br /> <br />... . . . . . . . . . . . " .......... BaJes TaX <br /> <br />, . . . . . . . . , . . . . . . . . .. ,.. Retailers Use Tax <br />. . . . . " .........,. " Consumers Use Tax <br /> <br />. . . . . . . . . . . . . . . . . . . , . . . . . . . . Parl.mutuel <br /> <br />. . . . . . , . . . . . . . , . . . . Income Tax Withho.lding <br />22 . . . . . . . . , . , . ., . Indillidual Income Tax <br />23 . . . , , . . . . . . , . . . , , . . . . Fiduciary Income Tax <br />24 " . . . . . . . . . Corporate Income and Franchise Ta.x <br />36 ,. ..'.... . ..... . Documentary Stamp Tax <br />. . , . . . . . Mechanical Amusement Device Tax <br />. . . . . . , " . . . . . . . . , SeveraJlce Tax <br />. . . . . , , . . . . . . . . . Estate Tax <br />.Cigarette Tax <br />. . . . . . . . . .. "'" Utter Fell <br />. . . . . .. ....... Lodging Ta.x <br />, .. '" '., .Interstate Motor earners Fuel Tax <br />, . . ,Motor Vehicle Fuels Importing Dealer <br />, , . Aircraft Fuels <br />. Special f ueis <br /> <br />44 <br />45 <br />46 <br />47 <br />67 <br />68 <br />71 <br />81 <br />85 <br />91 <br /> <br /> <br />... <br />- Q (f) <br />u.;l $ <br />S: .,,~.-., <br />',_. <br />, <br />:::II: .< <br /> Q <br />tA,) <:'> "'l <br />~ ,.! <br />X>o <br />::::s:: <br />;::; <br />c::;) ... <br /> ~ <br /> <br />oo;r <br />w <it' <br />r€~~.,a <br />,~ s--s e e: <br />~ g~<o ... (.;.? ~ <br />1 ~ .+: .., <br />r~f ,~! <br />z <br />p <br /> <br /> <br />