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<br /> <br />Notice of State Tax Lien <br /> <br />83......+)03463 <br /> <br />_101l1..E.._J~m:teIDL.__________.____..____.__.__________..____, .._lQJ{LE..___EWJ;JljJL__..____'_______.__.._______.___ <br />tUy' ' State ' Zip (,>~)'de 'CHv ' State Zfp Code <br />-itr.amLI.sland____.__NL_~________.__@.s.Q.L__..__.___l.gr.i.iJlg..J,;;JSl nd . ,______,_..NL____,.___.___.p_8.ftQl_ <br /> <br />This Notke of State Tax Lien is issued by the Nebraska Oepartl11ent of Revenue for ullpaid taxes pursuant to the <br />revenue lall1t'!: of the state of Nebraska, Notice is hereby given that bxes including penalties and interest, which are <br />shown below, are due from the taxpayer specified above and n:'l11aln unpaid after demand. These taxes constitute <br />a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. <br /> <br />Date of <br /> <br />Amot,lllt of Tax <br /> <br />Penalty <br /> <br />iota-rest <br /> <br />Additions <br /> <br />Balance of <br />Assessment Due <br /> <br /> <br /> <br />TOTAL $ <br /> <br />I t)@~'tjtbi' Ctutify that t,FiO Nebtit1t~'" Oljtp~rtrn~n1 of Be',j'tilnU~l l'l~~$ wltn We ~QventH! j-iiW~ 1)1' tt1(! SL.:l:h) of NebriH;ka In ttle' deter- <br />mmatH)n f.)/ tne dj'n'~t sho..'jj~ tt/ t.h~ d'~e, .;Ill"; t' (t l,j!t':PdY(tl htb'dIH-Q pay It!-f.t dm(J~)!l1 dW~J; after (h'!lniHld. if ttll~ Nutlct) 01 ~tate Tax <br />. LJ1&1l "s. .In ~Ud~m, ,.....ot oi~i;)f113ctJ"-1;l~"e" It '.f.'.' ?;:;t""'~ "'e D',onlY ,,' "," ".I~'> IOt~,~st '" I,," ./teet"" p,qp.rty 01 toe t..P.Y~f. <br /> <br />sign /" ~ -t:;~1..--'c..4; <br />~~ -:-~--~----,~- --7-- ~-:::~.+- .. ._~J8-83_____ <br />herL.:' __~s~.. .?'. ~.:a~.:.,~..~__..r..:~~~~83_ <br /> <br />,.,-p:ythoHzod St91' urtt D<!lte --- -~.._-_.__..- <br /> <br />r-====.~===__=:==~=~~=__.==_~~,~=~:~'E~,~._c_.~_~~:~y_..()_~!-_:_i_c_i_'A_t:..;~'.~.s_:~~..~' ., ---....-.'......'.....-'....--.-.....-----...---...---l <br />. -, ... " .. . . ,.,.........-.........,... . .....----.....-_..__,.__...,_..__J <br /> <br /> <br />NiiB;flASKA OEPART1\,u"NT Of' REVENUE -- White and Goldenrod Copies <br /> <br />T A.XI'A YER .. Pink Copy <br /> <br />COUNTY OFfiCE .... Canary Copy <br /> <br /> <br />'--' <br /> <br />L <br /> <br />--1 <br />