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<br />I <br /> <br />.i'lebnlska <br />, :r:::.nm:t <br /> <br />Notice of State Tax Lien <br /> <br />. Read instruCtions on Tttv..... tide <br /> <br />L.t.. Serla-t NumNr Lien Type Date Sodal Security Number <br />3/08/871 KJ Orlglna, <br />o Ranewal 8.5.83 83_004190 <br />Nebraska 1.0. No. County Lien Flied WHh $pouse"s Social SecurIty <br />3164144 Hall !Xl Reg)lter ~f Deed;Numt>er <br />I ~ County CI$rk I <br />I SUSIN&SSNAME AND LocATION ADDRESS --- TAXPAVER NAME AND MAILING ADDRESS I <br /> <br />8usfnesS- Nam.- <br /> <br />IName <br /> <br />1 <br />i t7., MilY'kPt TnC' <br />Street or OttHtf Malting Address <br /> <br />Boltzs.Market Inc. <br />Street- Addr..' <br /> <br />508 East 6th Street <br />City Stat-e <br /> <br />ZI p Code <br /> <br />508 East 6th Street <br />City State <br /> <br />Zip Code <br /> <br />Grand Island. <br /> <br />NE <br /> <br />6880L <br /> <br />Grand Is1~~ <br /> <br />NE <br /> <br />68801 <br /> <br />This Notice of Stale Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the <br />revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, wltich 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 foe real and personal property belonging to the taxpayer or hereafter acquired. <br /> <br />Tax f'etoiod <br /> <br />I Oat<< of <br />AaHSmtml <br /> <br />Amount of Tax <br /> <br />Pen..tty <br /> <br />ill-teres! <br /> <br />Balance of <br />ASHSSm&ftt Due <br /> <br />ITa" <br />1= <br /> <br />01 <br /> <br />I 01-01.83 thru <br />I . <br />101-31-83 r~-;>R-R3 <br />'02-01-83 thru <br />102-28-83 14-;>q-R3 <br />103.01-83 thru, <br />i 03-31-83 14-30-83 <br />I 04-01-83 thru <br />104-30-83 ;8-5.83 <br />I I <br />I 05.01-83 thru I <br />105-31-83 18-5.83 <br />I ! <br />! I <br />I <br />I I <br />I I <br /> <br /> <br />1?8 ::lO <br /> <br />OJ::! gt; <br /> <br />74 18 <br /> <br />166 33 <br /> <br />01 <br /> <br />40/1 7(; <br /> <br />-0- <br /> <br />1Q 87 <br /> <br />426 58 <br /> <br />01 <br /> <br />458.77 <br /> <br />-0- <br /> <br />i <br />i <br />L_ "lLOO i__ <br />1 i <br />i <br />5.80 -+--- <br />I <br /> <br />421 62 <br /> <br />17.07 <br /> <br />475.84 <br /> <br />01 <br /> <br />398.30 <br /> <br />12.32 <br /> <br />01 <br /> <br />368.74 <br /> <br />11AO <br /> <br />385.Q4 <br /> <br />I tlefeby >ClIfUfy th.t th. Nebf-bJ.;';'Cl Oeparlm~nt of Rl1l\leni.J~ h<i$ ~ompUetJ \Him We fovenU(t I.Wli of the :;,.tate of Nebf'U"'.iJ in the det.r. <br />mlnatlon of to. amount ~hown to be due, ..md the tltxpo)/er tf.;n f.1Utsd to p~)' ~he ~rnount du. ..tter demant3. It this NoUce of Stat. Tax <br />l.i.an If. an ex.ten~lon of an a.ffectlvo Hen it ie(V$S to contlOuo tntt pr/ortt)' ot {Me state's loteren in the .dfet;:ie<J prup$rty of the taxpayer. <br /> <br /> <br />si...~ w~- __3.evenue Aqent , ______ 8.4-83 <br />Jt~ ep.irer's-Sign.1ul'a ~ -'!te Date <br /> <br />i'j. .o"o.rT ~.: G: ~t;~'"~'o.,;::;~;;~~Q?'~::::::::-===:i_~~- I <br /> <br /> <br />N~~ OIil'ARTMENT OF REVENUE - Whi~ and Goldenrod Copi&. <br /> <br />TAXPAYER - Pink COpy <br /> <br />COUNTY OFFICE - eo....ry Copy <br /> <br />4-494-74 Rev. ".81 <br />Sypefs-ede~ 4..494.74 Rov. 5.3-0 <br /> <br />L <br /> <br />~ <br /> <br />L <br />