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r! .._. ~..,,:,6~ z ....a... :. _ .. ., - ~,, - . ,. ~,,,,,__ . ~.~- . INSTRl'-.^•TIONS YUHPOSE OP FORM. This form is to be used by the Nebraska Department of Revenue for the purpox of notifying the appropriate county authorities that a Notice of State Tax lien is being filed y gaigst [hc tCtpayer indicaud on thu form. ,~-s i The tax wugory number codes and the Nebraska tax programs they reprexnt are feud below. OI ............ . ................Sales Tax 02 ........................Retailers Use Tax 04 ...................... Consumers Ust Tax ...... Parrmutuel 1© ...................... 21 . , . , .. ~ . , . , , ......Income Tax Withholding 22 .................... Individual Income Tax .. . . . . . .. . .........Fiduciary Income Tax - 24 ...........Corporate Income and Franchise Tax 36 ...................Documentary Stamp Tax 4q ............Mechanical Amusement Device Tax - qj .... ........ . ...........Severance Tax 46 .... . ....................... Estate Tax 47 ...........................Cigarette Tax 61 .............................Liner Fee 68 ...........................Lodging Tax 71 .............interstate Motor Carriers Fuel Tax 81 ...........Motor Vehicle Fuels Importing Dealer 85 ..........................Aircraft Furls g I .................Special Fuels \.,,,:"~ n '*- \11.. `._~ zy~g^' ' h ~,\ m ^`_ ~ f~ ~y ~., ~. ~`~' i x rv- n rn n -, - ` rt, p 1 - --t rn ~ R ~ 7 r V C i !'V -. J T ' ~p ~ w G7 `y' u [L to _ - ~- :a ~ ~7 - M ° u~ Q ~ ~~~ Q ~~ v . , ~ ' 1 .L' ~ y N ~ + Y 0 G ~~.