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<br />.,fiebr.ska <br />department <br />- _ ,f revenue <br />U.n'-S-eiiaf Number <br /> <br />Notice of State Tax Lien <br /> <br />~.: <br />r- <br />" <br />~'- <br />',n <br />! <br />~, <br />f <br />~ <br />, <br />f <br />~ <br /> <br />3349438 <br /> <br />I Li!m Filed With is(JQUS4'S. Sodal Security <br />! P<1 Re-g1ste, of Deed Nl,.unber <br />I. Hall 29 Co.n" CI.,. <br /> <br />BUSINESS NAME. AND tOCATlONADDRESS <br /> <br />Uan 'fype <br />Xl Ori9inal <br />0- Renewal <br />County <br /> <br /> <br />.A8ad instructions on-'.verw side <br />Social Security Number <br /> <br />TAXPAYER NAME AND MAILING ADDRess' <br /> <br /> <br />Zip COde <br /> <br />3/121346 <br /> <br />507-38-7028 <br /> <br />N.bfQk<I-I>O~ No. <br /> <br />BusitiflS -N.,me <br />Golden Horseshoe <br /> <br />N.lme- <br /> <br />Carol J. Price <br /> <br />Street Addtti$ <br />402 South High Street <br /> <br />SttHt or Othftl' MaiUng Address <br /> <br />City <br />Cairo, <br /> <br />Stat!: <br /> <br />ZiQ Code <br /> <br />402 South High Street <br />City State <br />Cairo, NE <br /> <br />68824 <br /> <br />NE <br /> <br />68824 <br /> <br />This Notke of Slllle Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes porsuantto the <br />revenoe laws of the Slllte of Nebraska. Nolice is hereby given thatlllxe&iocloding penaltieslUldioterest,whicbare <br />shown. below, are doe from the taxpayer specil1<'d above and remain unpaid after demand. These1axes colIBtitute <br />a lien in the county for real and penonal property beloosing to the taxpayer or herufter acquired. <br /> <br />I T"" <br />Ic.~ <br />I N.....bor <br /> <br /> <br />thru <br /> <br />II Date of I <br />ASJeIIm..,t i <br />I f <br />! <br /> <br />Amount of Tak <br /> <br />P...oIty <br /> <br /> <br />333.93 <br /> <br />Tn Period <br /> <br />I nterlHt <br /> <br />Additions. <br /> <br />8alanc. of <br />A.-.s:ment'_Du. <br /> <br />01 <br /> <br />311. 18 <br /> <br />9.62 <br /> <br />01 <br /> <br />, I <br />1118-31-83 112-1-831 <br />;09...01-33 thru i-I <br />:09-30.;.83 112-1-83! <br />!l 0-01-83 thru I I <br />110-31-83 -+-12-l:-83L-.]02.2.L <br />, ' <br />I <br />I <br />i <br />I <br /> <br />299.39 <br /> <br />I <br />i <br />I <br />9.15 15.56 I <br />_.2,~5---i--.- 2.QL+ <br /> <br />I I <br />I I <br />I i <br />I -L-- <br /> <br />310.76 <br /> <br />9.25 <br /> <br />317.71 <br /> <br />01 <br /> <br />295.04 <br /> <br />01 <br /> <br />313.73 <br /> <br />-----------r--- <br /> <br />--L-. <br /> <br />TOTAL <br /> <br />$ <br /> <br />1,275.13 <br /> <br />I net"eby celtif-y \r,.ti Ill. ~bf4Sk. o.p{lJ"lment Qt Revenlltl rl&l cumpt~ with the '....enu. htW$ ()f the St~te of NeDrilSka In the deter- <br />mi1\auon of th-e .maunt $.ho-n tu b~ doe. ,uld tn~ lal(p.t't'lillf nas faU.., to p.~ the ilm~nt dua aft.r <i.m.n~. If this Notice of St.ltI!t Tax <br />,--l~n If, .-0 ..lwn-$~n Qt .Ill .,tKt1ve 1IV<l H ierve1 to ,-ontmta P\l~ priority of tne t-tat.~ Int..,-.lln UHII! aH.cted property of the taxpAyer <br /> <br /> <br />siga~~ Revenue Agent 12-13-83 <br />hir. "'~.'.xrt::2..1b TllI'SpeCial Aqent 00';2_13_83 <br />. AU'"';;;;:;:aC~t::' s..., Tit.. 0... <br />FOR COUNTY OFFICIAL'S USE <br /> <br /> <br />4.4;94--'4 Rev. ].81 <br />5ul)(tr~es 4-4!a4.74 R..-". 5-60 <br /> <br />J <br /> <br />.NEllaASKA DEPARTMENT DF ReVENue - _to end GoI_od C"",.. <br /> <br />TAXPAYER - Pink Copy <br /> <br />COUNTY OF F fCE -- Can.rv Copy <br /> <br />L <br /> <br />L <br /> <br />-.l <br /> <br />L <br />