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INSTRUCTIONS <br />PURPOSE OF FORM. This form is to ba used liy the Nebraska <br />Department of Reve[rue for the purpose of notifying the appropriate <br />county authorities that a Notice of State Tax Lien is being filed <br />against the taxpayer indicated on this form. <br />> ~ ~; - <br />''the tax category number codes and thrNebraska tax programs they <br />represent are listed below. <br />Ol ....................:.........Sales Tax <br />`` 02 ..........:...............Retailers Use Tax <br />! 04 ...................... Consumers Use Tax' <br />10 .............. ............... Part-mutuel <br />21 ...................Income Tax Withholding. <br />22 ....................Individual Income Tax <br />23 .....................Fiduciary Income Tax <br />24 ...........Corporate Income and Franchise Tax <br />36 ...................Documentary Stamp Tax <br />44 ............Mechanical Amtuement Device Tax <br />45 ..........................Severance Tax <br />46 ........:................... Estate Tax <br />47 ...........................Cigarette Tax <br />b7 .......... . .................. Liter Fes <br />6IS ...........................Lodging Tax <br />71 ... .........Inters[ate Motor Carriers Fuel Tax <br />g l ........... Motor Vehicls Fuels lmportitig Dealer <br />85 ..........................Aircraft Fuels <br />9I ..........:................Special Fuels <br />~ n cn <br />l +v ~- <br />o -; ±~ rn <br />(j ^1. J . ~~ ~1 f<t ~ <br />.t> M <br />e .~ _ ~_ 'I f C Q <br />4 ~ fA V ~ - <br />CCyy, ..~ A O '~ <br />g~ <br />_ ~ 1,`~ <br />Ca iii'.~i <br />~. <br />~\ <br />...J <br /> <br />