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<br />I <br /> <br />_. <br /> <br />l~neb"'J" <br />~artOlent <br />of revenue <br /> <br />Notice of State Tax Lien <br /> <br />81016020 <br /> <br />. Read instructions on reverse side <br />ISoclal ~~udtv Number t <br /> <br />I 5 6-50-8390 _II <br /> <br />Lien Fl!ed With Spouse"s Soclaf Secufity <br />[] R"'9lster of Oel!td~ Number <br />[]I Coun'y CI... 506-50'-2200 I <br /> <br />BUSINESS NAME AND LOCATION ADDRESS <br /> <br />1'1",... '-"n.. <br />I . [} o;~~i~a! <br />! ua Renewal <br />I County <br /> <br />! Hall <br /> <br />In,,,t.. <br /> <br />, '.- C-_~I_' ......~...~ <br />,-,~._- ~-~- ..-,. , - - -- "-- <br /> <br />1-16-81 <br /> <br />84- <br /> <br />00 381t.f <br /> <br />r <br /> <br />Nebraska 1.0. No. <br /> <br />12811203 <br />~ <br />Business. Name <br /> <br />elly <br /> <br />Zlo COd" <br /> <br /> <br />TAXPAVER NAME AND MAILING ADDRESS <br /> <br />~ <br /> <br />Name <br /> <br />Street Address <br /> <br />S"treet or ather Malting,Address. <br /> <br />State <br /> <br />3804 E Seed1 i no Mile <br />Iclty <br />Grand_ Island, NE <br /> <br />This Notice of State Tax Lien is issued by the Nebraska Department of Revenue for uupaid taxes }>ursuant',t..-theJ <br />revenue laws of the state of Nebraska_ Notice is hereby given that taxes includingpenaltiesand-liltereSt,whiilhate-. <br />shown below. are due from the taXpayer specified above and remain unvaid after demand. These taxescoristiture <br />a lien in the county for real and personal property belonging to the taxpayer orhereafreracquired; <br /> <br />j Tax <br />! ~~:o~ <br /> <br />Tax Period <br /> <br /> <br />Amount of Tax <br /> <br />22 <br /> <br />! 01-01-77 <br />, 12-31-77 <br /> <br />366 30 <br /> <br />i <br />----'-- <br /> <br />I <br />i I <br /> <br /> <br />" 'r.r <br /> <br />-"----,-,-.~_----......._,-_._- -.--r----~~-T----- I <br /> <br />._______~__._-.J I <br /> <br />I <br />I <br />, $ <br /> <br />TOTAL <br /> <br />445 <11 <br /> <br />I t'lefoby ;::Itllll'f tl1"t InQ NeOrUl<.oiJ O"p<lrtt'J1$.l! Uf R0\;""nUtl' h.n cornpll<<O wim tne t~venu8' 1<1I'W.$ of \h~ State of N-ebfalXa,Jn U,._oet,er.. <br />minotUon of the amount VJ{)wn to bot tHat, il:)o) 1:h~ t<i-,<payet r,<t!. railed to p.1y thE! 4m.Ol.tnt due aiter demolnd. If thl$. Notice of State TAX <br />. L!en~li ilO .tl'l.liIln~'on af an e"/~Jn It ~r\j'@:$ t,. r..ontlfl\>tI {'1o: pntHlly I...f the stille'$. llHerest In tJ..,. ollf1-ected prOpCI:rty of the t,JXp.i)'er. <br /> <br /> <br />SlgO" b / / Revenue Agent 7-16"84 <br />here' Pr~f. SI-g ~ r,u-" 04te <br /> <br />Soecia1 Agent 7-16-e4 <br />l'-:'!!ie Oa.t" <br />r------'--'~--~---._.~---~F-O.A-COUNTV-.OF-FlClAl.s-use-- <br /> <br /> <br />NEBRASKA DEPARTMENT OF RE:VENUE - Wh,teano GOldenroo Copies <br /> <br />TAXPAYER -- PInk Cop,/, <br /> <br />COUNTY- OFFICE - C8nery Copy <br /> <br />.:l.~94./4 Rev. ].t!.l <br />SUp~ts""ue.s "'~494~74 RfJII, 5-80 <br /> <br />u <br /> <br />L <br /> <br />L <br /> <br />.-J <br /> <br />L <br />