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<br />r <br /> <br />1I~_r.... <br />_art:ment <br />of fevenue -Rnd inttruC'tlonJ on n",e,w'$kIo <br />Lien Serial Numtl;lu.n "ryoe ----r DJflt_ _ - . . ISOClal Security Numb..r <br />K] Original I <br />4 06 302 0 Reno".' L.~!~~i~~ i 507-36-4622 <br />County jtif1n Filed-Wi~" SpcUM"S Sod-al-Seeurlty <br />l.ia Rsoi1ter 0' Deeds Number <br />4322215 Ha 11 r:J County C,.,k , <br />r---liUSINESS'NAMEANO LOCATION ADDR~_~i_--=-__~~YER NAM~!lND MAILING ADDRESS <br />Sus/ne:ss Name Name <br />Crock Pot ' Claribel Placzek <br /> <br />~;~~~~;;. "';, ~==~~-~_~_ - ~"~~;o~~ ;;,";';;;;" <br /> <br />City State Zfp' CQde City <br />Grand IslaI]L____J'!E_ ______ ___~~L____,___L..~anr!1_s]and__.___ <br /> <br />Notice of State Tax Lien <br /> <br /> <br />84:- <br /> <br />003288 <br /> <br /> <br />.78 <br /> <br />State <br /> <br />NE <br /> <br />This Notice of State Tax Lien is i'8Oed by the Ne~ka Departmenl.of Revenue for unpaid taxell pursuanpo'the <br />revenue laws of rhe stale of Nebraska, Notice is hereby given Ihal Iaxes includlngpenaUies and'inlerest, which are <br />shown below, are due from the taxpayer <permed above and remain unpaid after demand, These taxes constitute <br />a lien in the county for real and persona.1 property betonging to the taxpayer or hereafter aCqu.lred: <br /> <br />rra;-.r--.~~.-'.T~-!~~- I <br />I <<dtogory I Tax Period I A I Amo",nt ot Tax i Penalty <br />Number i . ' ssessment I _ --L- <br />i 12~01-83 thrlJ:; i <br />01 112-31-83 :5/15/84 L 288.47 . <br />- ---nll.-01-84 thru I --'1 <br />01 !01-31-84 15/15/84 I 252.43 <br />: 02-01-84 thrlJ i '; ; <br />'02-29-84 15/15/841 223.68 J 6.92 <br />! 03-01-84 thru I ! -------------:- - -. <br />'03-31-84 '5(03/84 ! -0- .02 i <br />r-'-- ~-'-'---'T._-----~~---l-~~ <br /> <br />r-~' <br />! <br />I <br /> <br />Interest <br /> <br />Additions <br /> <br />12.14 <br /> <br />21. 61 <br /> <br />7.81 <br /> <br />11.14 <br /> <br />01 <br /> <br />7.47 <br /> <br />I <br />! <br /> <br />______'---_.__, _ .____,_..__--+____._ I 1 <br />, ,,-. ...,__..i__~__ , I '-I <br /> <br />-_~._,____________ _~_____ _ _ _ ;,__ ._ ____ _L_______---.L____,j' <br /> <br />TOTAL $ <br />_________~___~~___...____ __ __ ____N_ _ ____~_.____ _____~.~ ~_,__~~___ <br /> <br />01 <br /> <br />.76 <br /> <br />-~..f-----._L__ <br /> <br />832.45 <br /> <br />I hllHeby ....nity tf1ilt PH! 1\1.1.",,,,,.4 {Jep.t.tm.,.Ht uj f.hYE'lIl"h'i h.is compLied witn tUe /'V!I'I:JOUllil '.ws. of toe St.HIlI of Nebraska in-the deter., <br />rnlnatJon of lh(j amoufll Si'\O-Wfl to be '::;...v. MId tne t-f~tI"'ytH h.a$ fallad W Pdy lnG iJllH)Unt Cue ..tftor dem~na. It Uli$f\fotlu-01_Stat-a-Tax <br />Ulln Is iW lll'it4tfl~lv(j oj an \,fl.cti"~ 1!~fI it ~1t,,,I't'> 10 >;:Q(,\lr;l)", ~hft POorib 01 thll ..t:lh"~ jrlU:-nnt In ttle 4JUKted property Qf tile ta.)(payot. <br /> <br />~ d..!Et '~!L_________ y,~Y.L~n.L______ 6/20/84 <br /> <br />".rellauH',sl t. C _. Q ___-~ T!tle ;t;0/84 <br /> <br />'" -s;f_ _~_____ _jpecial-c~.1._____ ( <br />,- AU-lhOrlZed 519 tUTti f rille Date <br /> <br />L~_~~~=_=:~~=~::::~~:~:::::::_::~:::::~<i~c:o.li:~I:i:~l:~~~::Ji~:::~==,-::~_____,_____.~______..J <br /> <br />sign . <br />here <br /> <br />NEBRASKA D-EPARTMEffi Qr- RE.vENUe- .. '....hili> 2iod Gb!;jtiMod- COPies <br /> <br />TAxPAYER ~ ?mk Cop,. <br /> <br />COUNTY OFF!CE- Cansf" Copy <br /> <br />4..H4~74 Rill"". 7-81 <br />S<Jpett>tlcfJ:i 4...l94.74 Rev. 5-80 <br /> <br />u <br /> <br />L <br /> <br />..J <br /> <br />L <br />