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<br />~~ <br />_. ,~~ ~-,~.~ ,~~-.~ <br />.-~~R, <br /> ~IU~~uEca-~o~ls <br />PURPOSE OF FORM. This form is to be used by the Nebraska <br />Department of Revenue fas tht purpose of noiafying 4he appropriate <br />county authorities that a Notice of State Tax Lien is being filed <br />ageirest the taxpay er indicated on this form. <br />~ <br />' The tax categary number codes and iha Nebraska tax programs they <br />represent are fasted below. <br />Ol' ...... .......................Sales Tax <br />02 ...... ..................Retailers Use Tax <br />t14 ...... ................Consumers Use Tax <br />10 ...... ......................Pori-mutue3 <br />21 ...... .......... . ..Income Tax Withholding <br />22 ...... ..............Individual Income Tax <br />. • .... ... . ...........Fiduciary Income Tax <br />24 ...... .....Corporate Income and Franchise i.17r <br />36 ...... .............Documentary Stamp Tax <br />44 ...... ......Mechanical Amusement Device Tax <br />45 ...... ....................Severance Tax <br />46 ...... ...................... Estate Tax <br />47 ...... ........... . .........Cigarette Tax <br />67 ...... .......................Litter Fee <br />68 .... • .. ..................... Lodging Tax <br />71 ...... .......interstate Motor Carriers Fuel Tax <br />81 ...... ..... Motor Vehicle Fuels importing Dealer <br />85 ... . .. ....................Aircraft Fuels <br />>i ...... .....................Special Foals <br />~I~ <br />~~. <br />~. ~~ ill <br />~~4 <br />~ ~~ <br />~._. <br /> <br />xa <br />m <br />cs <br />o ~, <br />~ > <br />a <br />r~ <br />rn ~ ~, . <br />:~ <br />t <br />coo <br />ti n rn <br />° `; <br /> <br />~ c m <br />n <br />i ~_~ ~ m <br />cu <br />o <br />~ <br />_ o "*a <br />~ <br />rr~ '*r~. ~ a <br /> <br /> ~. ~:~ i <br />r"~ ~~ <br />~ <br />~' <br /> ~> ,~a <br /> to r Q <br />x <br />cO <br />,~ <br />2~ _ _ <br />~ l -« <br /> N `~ ; <br />O <br />`~~~ <br /> <br /> <br />