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---- <br />,. <br />IN5~R1lCT10NS <br />YlIRPOSE OF FORM. This farm. is to be used. by the ~lebrasna <br />Deparmrenrof Revenue for thegurpose of notif}ingthe appropnats <br />q ~ ) { count}~ authorities that a No[s.:e of State Tax Lien is being Iced <br />~ <br />~ <br />against the taxpayer indicated on this form. <br />The tax ratecory number c~~les:urd theNebraska tax programs they <br />reptn ent are Iisted below. <br />01 .... Sales Tax <br />~? ... . ...... . ............ . Retailers lase Tax <br />p.1 ...... . . . .. ... . ....... i:onsumers Use Tax <br />iQ ...... .................Paritnutuel <br />I .. . ........ ........Income Tax Withholding <br />_? ...... . . ... . . .......Individual Income Tax <br />;~ ... ......... Fidu:.ian~ Income Tax <br />?4 ........... Corporate Income and Franchise Tax <br />36 ... . .... . . . .......I3o::umentary Stamp Tax <br />44 ........ - . . Mechu[icai Amusemen[ Ih»ce Tax <br />~> ... . .. .... ...... Severance Tax <br />~ .. Esta[e rax <br />4i Cigarette Tax <br />._.. <br />67 .. . .... .... .... ....:.:.......Litter Fee <br /> <br />?I ...... . ... . ..Interslate Motor Garners Fuel Tart <br />b 1 .. - ........ Motor Vehicle Fuels Importing Ikaler <br />85 Aircraft Fuels <br />91 . - ..... . .. .. .... Special Fuels <br />9 <br />r <br />~{~ <br />~lpv <br />~~ <br />~ # <br />A ~~ <br />?ti ~~~-~ <br />.Y V <br />PI y <br />S ~~ <br />a <br />-„~ <br />T <br />:7 <br />7A <br />i• <br />~. <br />M r rD <br />H '~ --1 M m <br /> QQ > W 7 <br />3>• 1 -d <br />~ .~ T - } ['~ <br />'+1 ~ „s [O <br />N <br />S.Z Y~ <br />rt ~ `~ ~' b <br /> n°-1 ~ <br /> <br />~. ~; <br />- :n, <br />~.. <br />rv <br />~ r ~ G <br />n <br /> '- <br />v- ~ <br /> ~ <br />Ql = ~ Y <br /> <br /> G <br />~'~ <br />~~~ <br />.. ~h.1. <br /> <br />