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_ _._..__ <br />Notice of State 1'ax Lien <br />nebraska <br />deDarimenT <br />df revenue' • Read instructions on reversaside <br />Lien Serra{.NUm ber LlBnTy Pe Oafe ~aciai 5 rity Number <br />04 sal ~ Re evva: 04-3o-sz 5os-s2-oro7 82- U01659 <br />N¢braskd ID. No, :County - L+en Flletl Wfth Spouse's Socia l5ecunty <br />~": Re9i5ieY Ot D¢Qtl51`IUmbef <br />3234754 Hall county ci¢rk _ I <br />BUSINESS NAMEAND LOCATION ADDRESS 7AXPAV ERNAME AND MAIL.NG ADDRESS <br />~BUSine55IVam a NamC ___- _ ~~ <br />Cuddle & Snooze Furniture ~ J. M. Peters _ <br />9Lreei Adtlre55( ~Sireat er 02Y,er Mallin9 Atldress <br />Box 156, ~ Route 2: Box 55 <br />City State Zio Code City StatC ZIpCotle <br />OgaTl'a1a, NE. 69153. ~ Ogallala, NE. 59153 <br />T1iis Notice of State Tax. Lien is issued by the Nebraska Depaztment of Reveuue for unpaid taxes pursuant to the <br />revenue laws of the state of Vehracka. Notice is hereby given than faxes inctudint; penalties and interest, which are <br />-shown ttelow, aze due from the taxpayer specified above and remain unpaid after demand. These razes cnnstitute <br />a lien in'the county forreai and personal property belonging'to the taYpa~er or Hereafter acquired. <br />Tax <br />Category <br />NumWr <br />Tax Peri <br />od Date of <br /> <br />ASStavttent <br />~ Amount of lax <br />i PenattV <br />~ tm¢rest <br />i. ' <br />Addit:ans Balance of -. <br />ASSessmeni Due > <br />' £Firu J <br />Ol 01-31-81: 3-05-81 5.00 5.00 <br /> -1-1 tru <br />Ol p3-31-81 6-30-81 5.00 1 ~ j 5.00 <br />- <br /> 5-01-$1 thru , `~ <br />O1 ' 85-3I-81 9-21-81 2.72 5.00 ' .32 , <br />~ 8..04 <br /> 6-Oi-83 thru , <br /> <br />O1 <br />6-30-81 <br />09-21-a1 i <br />19.74 <br />- <br />, <br />- ___-__. ~r <br />i 2.06 <br />~. <br />__. <br />_ f I <br />i I 21.85 <br /> 8-01-81 thru i ~ <br />. <br />_~~ ~.`~~ <br />Ol $-30-81 9-21-81 ' 15.21. 5.00 i 1:.23 " i 21.44 <br /> <br />- f <br /> ' -- <br />I -r-- <br />l ~-----~ <br />i <br /> .TOTAL S 51.33 <br /> f Hereby Certify that ih9: Nebfaska UBfJdrimen [-of Revenue: nasCam Pl.'-.f wltn tnc revert oe"laws aF the state of Neoraska o one :eter~ <br /> urination of the amount. mown to be tlue,anU tnetaxpnyer nos faitetl to pay. tneamaunt tlue a fter U¢mand. i' tnis Notice of Sta [e Tax <br /> Llan <br />~an extenSian 9t an ¢tfpCfiv! lien !t 5¢rve5 tU Conlin uC the prlot:ly at the S1ata Y in [erect In theaf t¢Ctetl pro periy ur CnCfax Pdy¢r <br /> SI111 / <br />. ~/ _,yt. y,~_,.,_„~ ~Q, j~ , <br />Revenue Agent 04-27-82 ' <br /> `.~~ <br />n __ <br />1. Pre Parer's:5tgrtatur ~ Tttie -- bat¢ <br /> - `1')`7 -%~ <br />Special Agent 04'-27-82 <br /> = <br />Autr hortz~0 51 nature Trtle _ _ <br />~ Date <br /> ~- ''FOR.000N7Y:OFFICLAL"S USE. ~~ ~~ <br /> <br /> NEBRASKA DEPARTMENT OF REV ENUE-Wlli~e andGohienrbd Copies - TAXPAYER-- Pink Cop y ~ ~ <br />COUNTY <br />OFFlC <br /> . <br />.. <br />E Canary Copy <br /> 4.494.7a Rev. /-&t <br /> Su pe rsetleS R-494.79:Rev: S-E0. <br /> <br /> <br />