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<br />ISneo,a",. <br />~artment <br />of revenue <br /> <br />r <br /> <br />-And- instructions on revetse sid.- <br />ISO<;131 Seeurity Number <br /> <br />Notice of State Tax Lien <br /> <br /> <br />504-36-6112 <br /> <br />4163001 <br /> <br />Ltcn Filed Wl,m SPOUSf;-"s Soci,d Security <br />I I [j Register of 06ed~Numb.et <br />1 Ha 11 I ~ County CllIJrk L <br />BUSINESS NAME AND LOCATION ADORJ;SS <br /> <br />Business Name <br /> <br />Name <br /> <br />Tri S <br /> <br /> <br />84,""'" <br /> <br />005778 <br /> <br />Street Address <br />')7'1 IJ OMo^~~ 11 <br />"",'" 11. $.If v.............,....., <br /> <br />Marie Onnen <br />lstreet Of Other MatHo9 Address <br />11<11 N lI'imlun~ <br />I ~.. ... ......_-,. <br />City <br />I Grand IS-l&:;d, <br /> <br />e Transmission <br /> <br />City <br />Grand Island. <br /> <br />Zip Coo. <br /> <br />5t-"l.t.... <br /> <br />NE <br /> <br />68801 <br /> <br />NE <br /> <br />,_:,_,,,"_:_,__' "',c,_:_,:--_.,, <br />This Notice of State Ta.~ Lien i$ msued by the Nebtaska Departmeut of Reveuue Jor uupaid~tali:""~f.Jti~,' <br />i"i:'t'"i'm~ ~ws ,,f th~ ;;ta~ of N€t~a~ ~oti~ i~ hereby given uliii tiUcs u-~~~:y..._ ~_!~~c~:~~:~~~ <br />shown beiow, are tiue from tile taxpayer specifIed above and remain unpaid afterdeman4,TIIelie'IltXeS'~te';: <br />a lien in the county for real and personal property belonging to the taxpayer or hereafter~uired: ~ <br /> <br />I :'iereby ;:.:;rtify tnat :ne N.br..t.....i!I Oopattm.erH ot f{ev@ctH.ifil 11.U <;:ompHeo with HHi fQV~t.!!!' Iltw$ of the St~t. of N*OfUia. in the o.t... <br />rninatlon of ;ne amoum \~own to t:e O..UI. 40<j In", t.lxpayer tin 'aHe<.1 to p.lY the ~mount all. .fter it.mana. If this Noue. uf Stab: T-:.:! <br />U~'1 '1. .0 'u(hm~~O["l of .n ~Hl!I!;t!\le !ten ~t ~ef\le.s to continue th~ Qrioflty of tne ttat$'$ intCloSt in tho affectoct propWty ct tM tuP*VW. <br /> <br />... OR l' <br />sign.. ~nptJf{t <br />her. rc "'......'. S~4'. ~'/~ ",,7 <br />~ ~__ _'_--.01:u::.. t2/ Special Agent <br />, .c..ut~~~~ /rr..___~_.____~ Titre <br />fOR COUNTY OFFICIAL'S USE <br /> <br />I c.i':;',y I <br />I Numb<< ! <br />~ _. _.. n. I <br />f UI-VI-O'f- tfU'UI <br />i 01-31-84 12-25-84 <br />i 02-01-84 thru I <br />i 02-29-84 _ ! 3-25-84 <br />! 03-01-84 thruf <br />i 03-31-84 ! 4-25-84 <br />, 04-01-84 thru! <br />04-30-84 i 5-29-84 <br />06-01-84 thru i <br />06-30-84 '7-25-84 <br />07-01-84 thru! <br />07-31-84 . 8-25-84 <br />, 08-01-84 thru! <br />08-31-84 ' 10-2-84 <br /> <br />T a)( Period <br /> <br />i Oat&Qf <br />1 A$H$SOlent <br /> <br />PenaltY <br /> <br />Amount of T u. <br /> <br />01 <br /> <br />18.83 <br /> <br />_ i}, '"".,~ <br />-r--... <br />i <br /> <br />01 <br /> <br />65.11 <br /> <br />5.00 <br /> <br />OJ <br /> <br />84.35 <br /> <br />5.00 <br />-r-- <br />i <br />,~"'_.~_~_+ . ~.~,:J:l::_~_"_,, <br /> <br />-...01 <br /> <br />73,03 <br /> <br />Gl <br /> <br />64.78 <br /> <br />5.00 <br /> <br />r11 <br /> <br />58.16 <br /> <br />5.0 <br /> <br />96.59 <br /> <br />5.00 <br /> <br />01 <br /> <br />T!!hl <br /> <br />NE8RASK.A OEPARTMEN;- OF REVENUE - White and Gof~nrod COPIt'S <br /> <br /> In_ <br /> 8.60 <br /> 5.49 <br /> 6.11 <br />L _4.45 <br />I 2.44 <br />! <br /> 1.49 <br /> 1.33 <br /> <br />Revenue Agent <br /> <br />TAXPAYER - ?:nk Copy <br /> <br />L <br /> <br />I <br />'-- <br /> <br />_11..... <br /> <br />64.65 <br />102..92 <br /> <br />TOTAL <br /> <br />1$ <br /> <br />520.80 <br /> <br />10-31-84 <br /> <br />0... <br />10-31-84 <br /> <br />0.&'. <br /> <br />COUNTY OFFICE -- C4n<<f'Y Coov <br /> <br />4-494~/4 R.h~ 1.31 <br />$l.lper'i@(jes.4.494.74 R..... ~.80 <br /> <br />u <br /> <br />~ <br />