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<br />1II~.b""" <br />.',d!P3rtment <br />of revenue <br /> <br />Notice of State Tax Lien <br />'84-004716 <br /> <br />!'fOTIce, OF ST~TE TAX UEN <br />INDIVIDUAL INCOItE TAlC <br /> <br />" <br /> <br />I <br /> <br />IF 100. INQUIRE ABOUT 'tOIJR <br />ACCOUNT . RfFER m THESE NUMBERS <br /> <br />soc. SEt. NO. <br />NeaR. IDENT. NO. <br />SPOUSE sot. SEC. <br />TAXABLE YEAR <br />UBI NO. <br />COIMTY <br />OATS OF NOTICE <br /> <br />505582305 <br />11734302 <br />NO. 506789852 <br />1980 <br />84055027 <br />HALL <br />02.124.184 <br /> <br />RAY L & MARY A MCCAIN <br /> <br />54 JIlCK lHG8IRD <br />"LOA <br /> <br />HE 68810 <br /> <br />THIS NonCE OF STATE TAX LIEN IS ISSLED BY T H: NEBRASKA DEPARTMENT OF <br />REVENUE FOR INDIVIDUAL INCOME TAX PURSUANT TO THE REVENUE LAWS OF THE <br />STATE OF NEBRASKA. NOTICE IS HEREBY GIVEN TI*T INDIVIDUAL INCOME <br />TAXES INCLUDING PENALTIES AND INTEREST. WHICH ARE SHOWN BELOW ARE DUE <br />FROM THE TAXPAYER SPECIFIED ABOVE AND REMAIN UNPAID AFTER DEMAND. <br />THESE TAXES CONSTITUTE A LIEN IN THE COUffl'Y RJR PROPERTY BELONGIIG TO <br />THE TAXPAYER OR HeREAFTER ACQUIRED. <br /> <br />AMOUNT OF TAX. <br />PENALTY. . . . <br />INTeREST (COMPUTED TO 02'24'84) <br />TOTAL AMOUMT DUE <br /> <br />. . <br /> <br />265.95 <br />13..30 <br />108.29 <br />387.54 <br /> <br />I HERESY CERTIFY THAT THE NEBRASKA DEPARTMENT OF REVENUE HAS COMPlIED <br />WITH THE REVENUE LAWS OF THE STATE OF NEBRASKA IN THE DETERMINATION OF <br />THE AMOUNT SHOWN TO BE DUE. AND THE TAXPAYER HAS FAILED TO PAY THE <br />AMOUNT DUE AFTER OE~ANO. IF THIS NOTICE OF STATE TAX LIEN IS AN <br />EXTENSION OF AN EFFECTIVE LIEN IT SERVES TO CONTINUE THE PRIORITY OF <br />THE STATE'S INTEREST IN THE AFFECTED PROPERTY OF THE TAXPAYER. <br /> <br />" LI!. u/i; <br />~:~~V;M... <br />PREPARER'S SIGNATURE <br /> <br />/) 1. <br />.MJ..~Mf-..~d..... <br />TITLE c. <br /> <br />..Wl!.i..... .. <br />DATE <br /> <br />(J Lf' / /~ ;;/ <br />.~~~;r.;~.. <br />AU'fHakIZED SIGNNfURE <br /> <br />. ,-'i f <br />. .: . }'~AC&--i '~;L, .J' <br />...~~........<~" ..... <br />TIT"E : ."" <br /> <br />-7'. :;. . :,/~! <br />...1............ .. <br />DATE <br /> <br />FOR COUNTY OFFICIAL'S USE <br /> <br />NEBflASKA DEPARrMENT OF REVENUE OFFICES <br /> <br />---J <br /> <br />If -you -have any Que.S\IO_nS ~!I!Iardm!l th~s notice, please contact the NeblclSka Department of Revenue. Box 94818, Lincoln, Nebraska 68509, 01 any of <br />thfl,_regiQ:o.al offio:es liS~e4- below. In Nebraska YOU may- also dlal toll ff~. your long dIstance access number and 800-742-7474 for assistance. <br /> <br />LINCOLN - 14021471.2971 GRAND ISLAND - {3081 384~829 NORTH PLATTE - (308( 532-8250 l <br />OMAHA - 14021 554,2065 NORFOLK - 14021 371-1620 SCOTTS BLUFF - 13081 632,3637 <br /> <br />NEBRASKA DEPARTMENT OF REVENUE - White and Canary CopIes TAXPAYER... Pink Copy COUNTY ~- Goldenrod Copy J <br />7.145-19 <br /> <br />L <br /> <br />L <br /> <br />~ <br /> <br />L <br />