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<br /> INSTRUCTIONS <br />PURPOSE OF FORM. '~: h5s form is to ix used h; •ue Ne6caske <br />t~epazurenr of he~2nue for the p¢rpose crt"ro~titytng the ~onropri3re <br />county autherritizs tha[ s Nntlce of Si2te law Lizn s 3efna tiled - <br />sgainsi the taxpayer ~nd ±cated vn this fog. <br />The tax categop- nun;b er vndes snd the Nebraska tax prograrn~ they <br />represent are listed belo w. <br />01 ...:...... ................. . .Sales?~s <br />ill .... .. . .. . . . . ...... Retailzts C~sc ?'ax <br />0» . . ... . ... ...... .... ~onsunlers C~se Tax <br />i0 .......... .................. Yarf-mutuel <br />_, ....... - - - - _ . - Income 3':rx 14ithholdine <br />.~ - ... _ ... Individual ir.crsa;e Tax <br />-- . . .. . . .... .. . . .. . . . . Fi~3ui:~an' income Ta.c <br />.`,4 ........ - . Corp~~rate hta>tre and Franchise Tax <br />35 i3t~umer.tarv Starnp Tax <br />}y .......... .. tilechanical :~muszmznt Dzate Tax <br />... .. ...... ~everance ?vs <br />Y~ ... .... ........ F:State T'as <br />}? ... .. ...f ihaTettr Tax <br />b. -.. -.. -- . - _...._ .. UtterFte <br />i>E+ - .. LnUgin~ i az <br />?1 .. - - . - Intersta[e ~loturCa:ricrs f:-cei Fax <br /> A1ota: Vehitie ~cels Imnortiog i}este: <br />85 Aucra~t Rtes <br />~'i - - - - - ......._. ...,- ... ...Jncaal Each <br /> „~ ~ o .o r, <br />'r <br />h~ t~~- ,~~ s r <br /> -- <br />i1 ~ n. <br />~ ~ <br />~ <br /> ~ N + <br />~ O N1 <br />~~ ~ <br /> <br />^ n ~~ ~.3 ~ ` ~ { <br /> ~ ~ <br />ri ~ ~ ` . l~• SQ ~.. <br />Z <br />S ' <br />` t <br />1 b <br />~ <br />k <br />y ~" <br /> <br /> ~~ <br /> <br /> .,t` . <br />~,~, ~ _~ <br />