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<br />'-~'-'-~d~ <br /> <br />~.......,...,....... <br />~men-t <br />..".....e <br />Lan-S.r'ilft'.N-umta-r <br /> <br />Notice of State Tax Lien <br /> <br />. Read- instructiOnl on ........ side <br /> <br /> <br />B3'"""'iJU 632 3 <br /> <br />miM'uw. 1.0; NO'; <br /> <br />LABin Filed With ISpou-se-'S- SOc!aJ Sec:urltv <br />~ R-e-glster -of Daad umbel" <br />fla,ll cl County Cl." <br /> <br />BUSINess_UE'ANOLOCATlON ADDRESS <br /> <br />U.n T'Ipa <br />I. .K] Orfqinal <br />D,R-4"A8:Wai <br />County <br /> <br />Date <br /> <br />3/11/296 <br /> <br />11- 3D-B3 <br /> <br /> <br />Graod Is1aod. NE <br /> <br />TAXPAVERNAMEAND MAILING ADDRess <br />...- Edward Hall d/b/a <br />I Watl'rbed Warehow;f' <br />~.ttee1 or Othe( MliUlng Addte5S <br />901 ,.J. ?nd <br />Cfty Stat-e <br />I Grand Island. PIE <br /> <br />Zip code <br /> <br />WaterbedWarehouse <br />$ttpt A<JdttlSS_ <br /> <br />3022\11; Old Potash 4ighway <br />City- State <br /> <br />-Zip Cod~ <br /> <br />68801 <br /> <br />68801 <br /> <br />This Notice "f Stale Tax Lien is issued by Ihe Nebraska Department of Rrvenue for unpaid tax~ pursuant to the' <br />"""'nue law. "fthe ..te of Nebraska. Notice is hereby given that taxes including penaltlos aud interest, wltiehare <br />sh-abe1ow. are due from the taxpayer .pecitred above and remain unpaid after dema",l. These. taxescomtitnte <br />aliimoiR,lhe,eouuty fo< real and personal property ""longing to the t""'payer or hereafter acquired. <br /> <br /> <br /> TaJe: Pmod I 0... of Amount of Tax Penalty Interen _.. of <br /> iA~t Astessrnent Due <br /> ,n5~0l-83 thru I i <br /> 1 <br /> 105-31-83 ~-15-83 I 110.59 6..29 6.88 I 123.76 <br /> 106...01-83 thru I <br />01 106-3Q..83 f-25-83 i 269~35 -11- 13.22 I 282.58 <br /> i <br /> 107-01-83 thru , I <br /> I <br />01 j07-31-83 111-16-831 541.10 16.74 20.13 577 . 97 <br /> !08..01-83 thru i I 378 22 : 11 70 i <br />OJ i08-31-83 r1-16-83! 9.57 399.49 <br /> 109-01-83 thru 1 i -..--""-'------'.-;-.-.'..-"----1 I <br />OJ 109-30-83 111-16-831 190.97 5.91 I 2 <'4 199.52 <br /> I .w, <br /> i 10-01-83 thru , <br /> ; i I <br />Ql 110-31-83 111-17 -83 i 260.85 a.07 .50 -I 269.42 <br /> I I ! -r <br /> I 1 ~ <br /> TOTAL :; 1,852.74 <br /> <br /> <br />I "o!Sf$by eatUfy l!"Iat rll. NeD-rnka t.~o.l,.tm<<1{ of ):f1l_PU'" flU compUed .....Hn ttl-f'c r.\I1IAu. Jaws c-t the State- of Nebu ..-..a In the detar. <br />mm.Uon of the olrn9unt S-"tJW;fn tQ u. duCt, aM the uxp;lytlr flU failed to PilY th. amount due .net dtttll.nd. It tl115 NoHu of Stilt. Tal( <br />L~ Ii. an e-idefi$tQD of kll <<,ffecth'. Hen It S~~ to -conHnlJ<e- ttle- iJrln!"ny of tne sf-ate<S ll'll.,_t in tile .Uacted pro~h' of tt\-e taxPl:Yef. <br /> <br /> <br />sip.~~ L~~/ <br />....-- ..... ~._~~. .. u" ~..4. . <br />.... - . 'I <br />- '" D :. d <br />~ Av-t-'1().rj~. >illIG " ..' <br /> <br />Revenue Agent <br /> <br />11 -30-83 <br />0... <br /> <br />TlU. <br /> <br />Sped a 1 Agent <br />nUB <br /> <br />11-30-83 <br /> <br />0." <br /> <br />I <br />, <br /> <br />fOR COUNTY OFFICIAL'S USE <br /> <br />NElIA:ASI';-A OEt'ARTMEi\lT OF Rev ENlJE -. W"',. _>Vi G<>i_"" Copie, <br /> <br />T AXPAYEA - Pink Copy <br /> <br />COUNTY OFFICE - Conarv C_ <br /> <br />4.494-74 Rev. 7.81 <br />SUIM~.l-4-494--74 RH.S.aO <br /> <br />u <br /> <br />L <br /> <br />L <br /> <br />..J <br /> <br /> <br />L <br />