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<br />.., <br />nebraska <br />dtlPartm.'" <br />.. .. of r..."~. <br />L1en Serial Number <br /> <br />Notice of State Tax Lien <br /> <br />83----004442 <br /> <br />NebrHka- J.D. No. <br /> <br />Lien Filed With Spouse's Social Security <br />.8J Register of Deeds Number <br />Hall K1 county Clerk <br />BUSiNESS NAME AND LOCATioN ADDRESS <br /> <br />Uen Type <br />o Original <br />[] Renewal <br />County <br /> <br />Date <br /> <br />. Read instructions on reverse side <br />Social Security Number <br /> <br />r <br /> <br />9 10661 <br /> <br />10-3-79 <br /> <br />505-74-8328 <br /> <br />3103986 <br /> <br />TAXPAYER NAME ANOMAfLlNG ADDRESS <br /> <br />BuSIness Name <br /> <br />Name <br /> <br />The Car-patMan <br />Street Address <br /> <br />3022 West Potash Highway <br />City Slate <br /> <br />Zip Code <br /> <br /> <br />City <br />I <br />I GrilnO I~lilnrl, <br /> <br />State <br /> <br />Zip Code <br /> <br />Grand Island. NE <br /> <br />fiRROl <br /> <br />NI= <br /> <br />68801 <br /> <br />This Notice of State Tax Lien is issued by the Nehraska Department of Revenue for unpaid taxes pursuant to the <br />revenu!' laws of the state of Nebraska. Notice is hereby given tbat taxes including penalties and interest, wbich 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 for real and personal property belonging to the tax payer or hereafter acquired. <br /> <br /> <br /> Tax. Period Date of Amount of Tax <br /> Assessment <br /> 5-1-79 thru <br />Q1 5-31-79 7-17-79 <br /> 6-1-79 thru 110-3-79 <br />01 6-30-79 <br />01 17-1-79 thru 10-3-79 947.70 <br />I 7-31-79 <br /> I 8-1-79 thru I ' <br />01 i 8-31-79 110-3-79/ 503.17 <br /> I <br /> I <br /> I ' I <br /> I I <br /> I I I <br /> <br />Penalty <br /> <br />Interest <br /> <br />AdditiOns <br /> <br />Balance of <br />Assessment Due <br /> <br />5 75 <br /> <br />38.77 <br /> <br />18.81 <br /> <br />34.18 <br /> <br />11,05 <br />2.52-1 <br />I <br />I <br /> <br />9 <br /> <br />15.56 <br /> <br />51'1 ?5 <br /> <br />TOTAL <br /> <br />$1.577.52 <br /> <br />I hereby cortify that the f\lebraska Department of ReVelll.le has compiled. With tho reV1tnue laws of the State of Nebraska in the deter. <br />mio.,Uon of tile amount shown to be doe, and the taxpayer has failed to pay the itlnount due olfter demand. I~ this. Notice of State Tax <br />Lien is an extensjc.-n of all efftK.tive lien it $9r\(eS to continue the priOrity ot the state's interest in the i1ffeeted property of the taxpayer. <br /> <br /> <br />Revenue Aoent <br /> <br />8-18-83 <br />Date <br /> <br />T!tle <br /> <br />Special Agent <br />Title <br /> <br />8-18-83 <br />Date <br /> <br />FOR COUNTY OFFICIAL'S USE <br /> <br />.__,___.___--1 <br /> <br />i\IE8RASKA DEPARTMENT OF REVENUE - White and Goldenrod Copie, <br /> <br />TAXPAYER - Pink Copy <br /> <br />COUNTY OFFICE - Canary Copv <br /> <br />4.494-74 Rev. 7.81 <br />Supersedes 4-494.74 Rev. 5.80 <br /> <br />u <br /> <br />L <br /> <br />..J <br /> <br />L <br />