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<br />INSTRUCTIONS <br />?URPOSE OF FORM. This form is to be used by the Vebraslta <br />Department of Revenue for the purpose of notifying the appropriat¢ <br />r county authorities drat a Notice of State Tax Lien is being ftled <br />igainst the taxpayer indicated on this Corm. <br />The tax catrgory number codes and the Nebraska tax programs They <br />represent are listed below <br />01 ..................:.:: , .....:Sales Tax <br />0'- .::.. , .Retailers Use Tax <br />04 ...................:.'_ Consumers Use Tax.. <br />10 .....................:...... Pazi-mutuel <br />1 ...................Income Tax Withholding. <br />-? :.....r:....... Individual'Income Tax.: <br />''-'3 .............:.....:.Fiduciary Income Tax <br />24 - - :. , .Corporate Income and Franchise Tax <br />36 ......: _ ......:....Documentary Stamp Tax <br />44 .... .::..:...Mechanical Amusement Device Tax <br />4~ ...........:... .. Seve>ance Tax <br />--~--- <br />46 ......... . . . .... ......... Estate Tax <br />47 . . . . . . . . . . ..................Cigarette Tax <br />67 .:.....::..: _ ... .... _ ' ...::Litter Fee <br />68 . `....: _ . _ ...... `....:.......Lodging Tax _ <br />71 - : - • • - .:.... `.Interstate Motor Carrieis Fuel Tax <br />81 .:.........Motor Vehicle Fuels Importing Dealer <br />85' , _ ......::..:..: _ .....:' ..Aircraft Fuels <br />91 :.......:.....:............Special Fuels <br />~ ~ .ei ~ <br />~~`~ _ rv '" ~ _. <br />~'~ s ~ <br />,~. ^~ °' ~ <br />\x <br />~ ~, <br />\\~ <br />y <br />r\ <br />~v` <br />\~= <br />