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<br />I <br /> <br />-- brook', <br />tIriS <br /> <br />Notice of State Tax Lien <br /> <br />.....SS4f... <br />....1OIIIT.... <br />SPOUSJ...sot.. set. NO. <br />nxaauYEM <br />Lt.... <br />UaltftEASE NO. <br />c:otI!ldY <br />._ OFlIOnCE <br /> <br />san..... <br />ZftS'" <br />SOMUtM <br />1919 <br />_1-..1' <br />8S29lMT <br />HALL <br />lWZUIJ <br /> <br />~ C "....VlItlEOFEl.:T <br />IItGUft Z .. 65 <br />UMD ISLAND <br /> <br /> <br />DI..... OF$T'. TA. UEN <br />_n..... I_tu <br /> <br />I <br /> <br />SF ~I""'" ...,...~ <br />ACc:ouNT. ..IItIfIM.. '* .1'M8E....as <br /> <br />........,. TO THE IlWliM'l UiIS IF THE STATE OF NUMIU.......I~E.U <br />....... Gl_" BY TJE ,eRlste. ~.. OF .......1' 1NE fIInCI: OF <br />STATE TAX UIN ...ICttHAS 8HJt DUl..Y FtLEDAUJNST THE QCMl.. NMiEo <br />n.Ava POIt INDIVIDUAL IfCOtIE 1'AXE$ IS 01 SC",ItHD. <br />I HIIlEBY estnFY lMAT THE IIHRASltA OEPAIllMENT OF RlEVEMIE HAS COMPUE8 <br />1B1M THE IlEVl!llU& LAIfS OF 1ME STATE OF _UU IN ntEOEl'ERIUIMnGftOF <br />lIflS OlSQtMSE. <br /> <br />~~. <br />.......s U-*1UlE <br /> <br />. Q. . ::f.tO~f1- <br />~Sl~ <br /> <br />.~.tJ~uKd..... <br />TtTU .~ <br />~~.. <br /> <br />.(~:L~.~.... <br />DATE <br /> <br />.,~~~~... <br />DAfii" <br /> <br />FOR CGUII1"Y OIFlC tAL'S USE <br /> <br />j <br /> <br />---I <br /> <br />NUIlASKA OEPARTMENT OF REVE"!..UE OFFICES <br /> <br />If )/"OU t\6Y4. any Q\ldtiona. t~dJnQ th~s nQlu;,.,. .p!..~ (;D'nl~t \j"'. Ne~.":k. Oe~rtmant 01 R."*l'hJfII. Sa. 94818, Uo<:ojn, Nebrask,,-68S09. Of any of <br />t"-~~ off~H$t_ ~OW. 11'\ N.oru!ol;o1, VQU mol" <tH.Od-ial tOIl he. }tO~f la./'l.!j,l dlnar'H:~ ilC<:-~J numbe! an(J .BOO~14.2.1414 tor .>>..taO<;:8. <br /> <br />~IHCOUI- I_, 471a71 <br />0MA>lA - _,__ <br /> <br />GRANO ISLAIlIO .- l308i 384-6829 <br />NORFO~J( - 14021311.1620 <br /> <br />NORTH PI.ATTE - (308) 632-8250 <br />SCOTTS B~UFF - 1308) 632.3637 <br /> <br />NlJAASAA DEPARTMENT Of REvENUE - Wh,tt~ and C<<n.ty C'OP1~ <br /> <br />r AXPA YER - PIf'lk Copy <br /> <br />COUNTy -< Golchmrod COLlY <br />7<145-79 <br /> <br />~ <br /> <br />"......... ~..y, :;.,-_.<<" .';-----. -,. ~~ <br /> <br />L <br /> <br />..J <br /> <br />L <br />