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<br />~\ <br />~~` <br />i <br />l <br />~~ `'~/~ <br />\~x <br />`~`~ ~~ <br />r ~. <br />~ i <br />~- t <br /> <br />INSTRUCTIONS <br />PURPOSE OF FORM, This:form is to be used 'by ,the Nebraska <br />Department of Revenue faYthz purport of notifying the'approprlate' <br />county authoritiCS that a Notice of Sate Tax Lien is being filed <br />against the raxpayet intlicated on this form. <br />The tax category number codes and the Nebraska'#ax programs they. <br />represent are Jisted below. <br />01 ........ ... _ _ .. _ ..:....:.. :.. Sales Tax <br />(I2 ... ....... • ............Retailers Use Tax <br />~3 ..... .....:.. ..::... ConsumersUstTax <br />] 0 .... .............:......:. , Parrmutuel <br />] . . . .............. .Income Tax Withholding< <br />='- Individual (ncame Tax <br />23 .................... . Fiduciary Income Tax <br />24 - ~ . - - ......Corporate Income and Franchise Tax <br />35 ..... ... . . . .......Documentary Stamp Tax <br />44 ............Mechanical Amusemant Device Tax <br />~~ .. ........ ; ..........:...Severance Iax <br />d6 .................. .. Estate l'ax <br />. <br />47 . . . . ......... <br />...'. .. ..... .:_.Cl~'3ic'Ite Tax <br />E7 ............ _ ....:.. . ....:...Lit ter Fee <br />6ii ...... .:..:.....:.'...... Lodpr.g Tax <br />i , ..:.......Interstate Motor Carriers Fuel Tax <br />81 ......Motor Vehicle Fuelsifntportir;gDealec <br />$5 .... . ........:....: . ...... Aizcraft Fuels <br />91 ......:.............:......Special Fuels <br />,, ~ <br />c <br /> <br />4 <br />r <br />~ M <br />- m W n <br />7 <br /> ~ ` O ~ (7 <br /> { C <br />1 1 <br />~ A <br /> <br />~ m <br />~F i <br />O <br /> j vC S~.) 3 <br /> <br /> N I i 1 ~ Cr) <br />7 <br /> <br />