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<br />II. Sneor.,k. <br />department <br />of revenue <br />Lion Set-Ial Number <br /> <br />Notice of State Tax Lien <br /> <br />4 11 797 <br /> <br />,. ';to Typo <br />j]) Original <br />o Rtn'eW.! <br /> <br />Date <br /> <br />. Read iRltNctions on reve... lido <br />Social Se<::urlt.... Number <br /> <br />r <br />I <br /> <br />11-1-84 <br /> <br />84-005821 <br /> <br />Nebraska t.O. No. <br /> <br />I ~n !iI~~ Wtt~ _ _ ~~~~~ $0(.:1.1 Se(:uTlty <br />! L!) K69U,tllY of uevosr"'-l'''UVf <br />Ha 11 []j Coonry Clark <br />BUSINESS NAME AND LOCATION ADORliSS <br /> <br />County <br /> <br />4573668 <br /> <br />TAXPAYER NAME AND MAILING ADDRESS <br /> <br /> <br />CIty <br /> <br />State <br /> <br />Zip CQ(fe <br />6b&01 <br /> <br />Name <br />Restaurants Inc. of Grand Island <br />Strdt or OthQ~ Malting AddreJs <br />77C N. c.otner Suite 300 <br />IClty st~te. <br />Lincoll;, NE" <br /> <br />68504 <br /> <br />Si,iiifiifi$ Name <br /> <br />Restaurants Inc. of Grand Island <br /> <br />Street Address <br />~4Z1 W. State St. Plaza 6 <br /> <br />tY'iir:( Islanc. tlE <br /> <br />This Notice of State Tax Lien is issued by tlw: Nebraska. Department of Revenue for unpaidtaKes<ptmiWU1tt~tbe' <br />revenue laws of the stale of Nebraska. Notice is hereby siven tbattaxelI including penaltieltandmteltit,'l!ibidt'are <br />shown below. are due from the taxpayer specified above and remain unpaid after demllnd.nesetllXe5coD$titllte <br />a iien in ihe county fiJr :=1 and personal pro.petty belongiD,. to the taxpayer or here8fter acquimf~ <br /> <br />01 <br /> <br />I Tax: Per-iod AmQunt of Tax <br /> <br />19~-~!-c.4 thru1 '. , <br />; UI-3HA 18-1i'.::84 L-~9.:.9'!.-.-..._ <br />I 02=01 =84 torul I I <br />102-29-84 ,8-14-841' 573.93 I' 17.75 48.65 <br />l 03-01-84 thrul I ! <br />103-31-84 18-14-841 618.32 I 19.12 45~06 <br />! 04-01-84 th~ j i ! <br />! 04-30-84 --1..8-14-841 405.57 _J__g.5~---L 24.89 <br />05-01-84 thruI I I I <br />05-31-84 d 18-14-841 359.80 ! 11.13 /17.80 <br />06-01-84 .nrUI : <br />06-30-84 18-14-84 i 237.01 7.33 9.00 <br />i I I <br />L_J <br /> <br /> <br /> <br />I <br />12:53~34'; , ii,' <br /> <br />I. ......................,.............~~ <br />I. $2M7.al// <br /> <br />r TilX <br />I Category <br />i Num-ber <br /> <br />01 <br /> <br />01 <br /> <br />01 <br /> <br />01 <br /> <br />01 <br /> <br />TOTAL <br /> <br />Titl. <br /> <br />Revenue Agent <br /> <br />i1:1-84.... <br />oaa <br /> <br />11....1..84' <br />~<= <br /> <br />f--=-~"" _ <br /> <br />FOR COUNTY O'-fit(;IAi.. ':) use <br /> <br /> <br />NEBRASKA DEPARTMENT OF REVENUE - White and Gnldenrod CO(>>es <br /> <br />T AXPA YEA .- Pink Copy <br /> <br />COUNTY OFFICE - Canary CQll\I <br /> <br />4-4-94-1.4 R.-.,.- 1--8-1 <br />Sl.:~f"it>~i ...-4~..t..14 ii-v. 540 <br /> <br />L <br /> <br />L <br /> <br />L <br /> <br />L <br />