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_~U.,_. <br />..e.. . ~,,._., <br />- INSTRUCTIONS <br />PURPOSE di: FORM. This Conn is to be used by the Nebraska <br />Department of Revenue for the pnrpase of notifying the appropriate <br />county authorities that a Nance of State Tax Lien is being Tiled <br />agaittst the taxpayer indticated an this farm. <br />~, ; ~ ~ ~ t .The tax category number codes and the Nebraska tax programs they <br />represent aze listed below. <br />t)i ... . ..: . ..................... Sales Tax <br />02 .............. . . ........ Retailers Use Tax <br />tl4 ...................... Consumers Use Tax <br />i Q ............................Pori-mucus! <br />21 ...................Income Tax Withholding <br />....... . . .... Inditidtud Income Tax <br />23 .....................Fiduciary Income Taut <br />?4 ..... , .....Corporate Income and Franchise Tax <br />s6 ... . ...............Daeumentary Stamp Tax <br />•W ..... . ....... 4lxhanical Amttsement Device Tax <br />45 ........................Severance Tax <br />3Ct .................... ....... Estate Tax <br />37 ... ..... Cigarette Tax <br />°7 ... .......... ...........Litter Fee <br />t+Fi ... ...........Lodging Tax <br />'1 .. laterstate `Aotnr Cazriers Foe! Tax <br />ht .. ........!AatorVehi,:3:,Fue:stmpartingDeakr <br />85 3trcraft Fuels <br />91 .. Specie! Fuels <br /> 4 <br /> <br />+y i'1 era <br />.y <br />Rt <br /> G'J ~ ~ ~ ~ <br /> <br />R~ ~ iV -sni ~ C"~ a <br />\ s E ~ m <br />t\ <br />~ Y ~ ti~T ~ <br />.~ <br />~ ~ n ~"w' e,0 ... ~ I ~ <br />t\ <br /> <br />t: ~ <br />r <br />~, z.ee <br /> <br />w <br /> <br />~ _ a <br /> <br />~ ~ s - ~ ~ <br />~~ <br />E.a <br />` ~ <br />' <br />1 <br />!~ <br />~ <br /> <br />~ <br />-- 't <br />~ - - -z.. <br />~ <br />" ~ _..-- <br />C`:. <br />~,. <br />, <br /> u <br /> ~ ~ <br /> <br />