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<br />U*, Serial Nurnbftr Lien Type D;jIte ,,,'.' -""" "'-.. j <br /> !XI Original <br />4/05/060 o ReneWiii 5-11-84 J <br />Nebulk.a LO. No. County Won Filed Wltn 84.--1011'573 <br /> [] Register of OIled s:o~~: ~~;'~~?c:,lty <br />3940373 Hall [j. Cou~ty Clerk Number .' <br />I BUSINESS NAME AND LOCATION ADDRESS TAXPAYeR NAME AND MAILING ADDRESS I <br /> I <br />Bu.lne55 N~m. Name <br />Bourbon Cowboy Larry Hob~ <br />Str..t AadresS Street or Other MaIling Address <br />"no ~ ,th I n.r I t 71'; <;tl h R <br /> <br />I" <br /> <br />lI~neb'ask' <br />_artment <br />of ,evenue <br /> <br />Notice of State Tax Lien <br /> <br />. Rnd instructions on fewrse sKI. <br /> <br />r <br /> <br />01.... ..., Ie;, <br /> <br />Stat~ ----.~--~~COdl!----.~~~ ~ __u..r ..oad <br />.NL--o-+-- ____....Q.8.00l-__..1.\irgnd Is land , <br /> <br />Grand [~land, <br /> <br />State <br /> <br />Zip.Code <br /> <br />NE <br /> <br />6a80l <br /> <br /> <br />This Notice of Slate Tax Lien is issued by the NelJrasb Department of Revenue for unpaid taxes pu_tothe <br />.....enue law. of the slate of Nebnska, Notice is hereby given thaI laxes including penalties amHnierest;. wbkh:_: <br />shown below, are due from the taxpayer specified above and temain unpaid after demand, Th... laXeaCOllttitlite <br />a lien in the county for real and personal property belonpng 10 Ihe laxpayer or hereafter acquired, <br /> <br />l 0-.,. of <br />i A-....n..,t <br /> <br />Amount of Tax <br /> <br />--r <br />P.nllitv I <br /> <br />il <br />138.70 <br /> <br />i' Tax [ <br />=1 <br />! 05-01-81 <br />01 i Q~- ~~-82 <br />i u..-u i -82 <br />21 I 06-30-82 <br /> <br />T.. Period <br /> <br />thrul <br />I <br />I <br />tfWUi <br />i 8-10-82. <br /> <br />2828,96 <br /> <br />94.13 <br /> <br />4.71 <br /> <br />, <br /> <br />i <br /> <br />~._.. _ _.~ -.---i-- - -~ <br /> <br />--~l <br />: <br /> <br />In_ Addido.. <br />970.87 <br />23.42 I <br /> i <br /> [ <br /> I <br /> i <br /> I I <br /> I I <br /> TOTAL I $ <br /> <br />a.lonOoof' I <br />~j)... <br /> <br />3.938.53 <br /> <br />122.26 <br /> <br />, ' <br /> <br />----- L__---I <br /> <br />I li.teDy caftify tl'\.t the i"H:o-f.S~ O.p.utrn'6nt l')l R.\HlIl,m flU cQmpflell with the r.....nuel.W5 of the St.t. of Nebraska in tn.det.r. <br />min.Uon of the .mo-unt Shown t-o ~. due. ilniJ tho tax;)lty.' has falll!Kt to pay tfl. .mount due ..tt... dam.no. If this NQtl~ (If State T~x <br />LIen is an ext on of ~o efflKt H~n It ..rvas t.o contino." th~ pflOflty 01 tile $ta'e', lnt.,_t In the ."<<ted prQperty of the ta.")'.,. <br /> <br />5- 11-84 <br /> <br />si.. <br />".r. <br /> <br /> <br />Titl. <br /> <br />Special Agent <br /> <br />4,060.79 <br /> <br />____Special Agent <br />Title <br /> <br />FOR COUNTY OFFICIAL'S USE <br /> <br />NE8RASKA O€PARTMENT Of REVENUE ~ WhiU and Goidenrod COOUts <br /> <br />TAXPAYER - Pink Copy <br /> <br />L <br /> <br />L <br /> <br />l_ <br /> <br />O.te <br /> <br />5- 11-84 <br /> <br />0... <br /> <br />COUNTY OFFICE Caner.,. Copy <br /> <br />4-494+14 R.y, N 1 <br />Supersede, 4494-14 Rev, 5.i 0 <br /> <br />u <br /> <br />-.J <br />