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lNSTFtUGTI®l~IS <br />PURPOSE OF FORM. This form is to be used by the Nebraska <br />Depamneni of Revenue for the purpose of notifying the appropriate <br />county authorities that a Notice of State Tax Lien is being Filed <br />against the taxpayer indicated an this form. <br />The tax category number codes and the Nebraska tax programs they <br />represent are listed below. <br />AI ....... ......................SalesTax <br />62 ....... ............... . .Retailers L'se Tax <br />04 ....... :.............. Consumers Use Tax <br />f0 ....... .....................Parrmutuel <br />21 ....... ............Income Tax Withholding <br />22 ....... ............. Individual Income Tax <br />23 ....... ..............Fiduciary Income Tax <br />24 ....... ....Corporate Income and Franchise T~:• <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 />91 ....... ....................Special Fuels <br />~~ <br />`-~7 <br />,fit <br />. <br />~_ <br />t~ r~.. <br />~;> <br />m +~' <br />n <br />-+~ !~ <br />T 6~~~y <br />rn 3 <br /> <br />R~~~. <br />~.; ,~ <br />ca n cn <br />N p _q <br /> <br />m <br />'~ ~ ~ ~ ~ <br />~ ~ rrf <br />~ ~ <br /> <br />1'V p <br />~ ~1 m <br />t~- <br />C7i '1't _rr <br />N <br /> ,1 <br />r ~! ~ ,7 z <br />c` m <br />b {" .'~. J 3 ~. ~ 0 <br />~ r- D <br />ur ~ ~ ' ~ 'o ~: <br />`- " t3. <br />c <br />ca i cu ~ ~ <br />w 0 ~ F-+ <br />co ~ <br />ti ~ ~ ~ <br /> 0 <br />~c <br /> <br /> <br />