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<br />I" <br /> <br />,... <br />IIE:' <br /> <br />sac. SE~..NO. <br />MftIR... ...IOEHr.NO. <br />SPO!J$E soc. sec. NO. <br />TAXABLE ynR <br />l.IBtNO. <br />UBi RELEASE NO. <br />COIMTY <br />[);,l'EOF HUTICE <br /> <br />506123746 <br />170'5504 <br />129321iflt6 <br />1978 <br />81253054- <br />83~94 <br />HALL <br />12.106/83 <br /> <br />RAUH It to. MAIlYJ STREHU: <br />92SSGREENWICH <br />GRAIC) ISLANO <br /> <br /> <br />Notice of State Tax'Lien <br /> <br />OISCW4R.e OF STAl'lTAXlIfH <br />INDIVIDUAL INcoME TAX <br /> <br />I...YQl.t...I8QU;IA&: A8WT YOUR <br />"&OWT..... RI;..a.. TO . TRESE.. NUfl8ER.S <br /> <br />NE63S01. <br /> <br />PURSUANT TO THe REVENUE lAWS OF THE ST ..TE OF NEaAASKA .OOTtCE.IS <br />HEtl&Y GIVeN SY TiE tE8ltASKA DEPARTMENT OF IH:YENlJE THATTHlil'NOT1CS OF <br />STAlE TAX i.IEN WHICH HAS &E'EN 'OULY FILED AGAINST THE AROVE H."-O <br />TAXPAYER fOR INDIVIDUAl INCOMe TAXES IS OISCH'RGEO. <br /> <br />ItEilEISY CERTIFY THAT THE NF.8RAS.KA DEPARlMEln OF REVENUE HAS COMPLILil <br />liflnt THe R.EVatUE LAWS OF THE STue Of NEBRASKA IN THE OETERMIMATIOlf OF <br />'MIS DISCHARGE. <br /> <br />" j L . __ , lLl/i b7 ~._J <br />~~. ~. / .~?.... <br />PREP"RER t S SIGNATURE TIRE' <br /> <br />~cnCJ?r.~~ <br />. ~-. ! . . ..... <br />AU ... lZED SIGNAT E TIT <br /> <br />.(.~d{i!.... <br />DATE <br /> <br />..IA.'/~~K~.. <br />DATE <br /> <br />FOR COUNTY OFFICIALtS uSE <br /> <br />';0 <br /> <br /><0 <br /> <br />NEBRASKA OEPARTMENT OF REVENUE OFFICES <br />J1 yow ~ .-n>>- uuatiOftl '..-to",", thiS flOH~e. ~INle ,"-QIltRt the N41t.nas.... Qep.f'lm."t 0' ~....enu.. BQX 94118. .LinColn, Netjr..Skill 68$09. or Any Q~ <br />tM ~ oftkft IUted~. ~f'l Nebf~. )'OU molY .i$Q Qt.. toH tree, "fout 10"9 dist,anc.e ac:ceu t\umbet .nO 800-142'7.174 ror ani:nanc.e. <br /> <br />c ~ASKA OiPARTMEHT Of -REVENUE - Wh~k and Canary COpj~~ <br /> <br />r AXPA yER -. Pink Copy- <br /> <br />COUNT V ~" GOI08ntUd Copy <br />7-145-19 <br /> <br />~ <br /> <br />UNCOUl- _ ~n.an <br />..QIIIWIA- _1__ <br /> <br />GRAND ISLAND - 13081384_ <br />NORFOLK - 1402. 31H6ZO <br /> <br />NORTH PLATTE - 13QlI. 532.aaso <br />SeOTTS 8LUFl' - (3081 632-3831 <br /> <br />L <br /> <br />L <br /> <br />..J <br /> <br />L <br />