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=ttabradta <br />t <br />Notice of-State Tax Lien <br />• Road inetruetiom on reverse Lida <br />Uen Serial Number lien Type <br />Or191na1- Date - Social Sseurity Number _r ~~ <br /> <br />~ <br />2iY1/684 p Renewal 11-22-82 487-42-6162 ~% <br />Nebraska I.D. No. County - eJSn-Filed With' Spouse's Social 5ewrlty <br /> ~1 Register of Deetls Number <br />3212165 flal l $1 county clerk <br />BUSINESS NAME AND LOCATION ADDRESS TAXPAVER NAME AND MAILING ADDRESS <br />Bilslness Name _ "" <br />St~riri s Robert 8. Thompson <br />Sk{eel Address Street Or Other Mailing Atldress <br />1300 South Loeust, Suite C P:O. Box 1761 <br />City - State - Zlp Code Clty State Zip Cpee <br />-brand Island, NE 68801 Grand Island, _NE 68801 <br />?hie Notice of Slate Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the <br />revenue laws of the state of Nebraska. Notice is hereby given that lazes including penalties and interest, which are <br />shown below, are due from the Taxpayer specified above and remain unpaid after demand. These taxes constitute <br />alien in the county for real and personal property belonging to the taxpayer or hereafter acquired. <br />Tax <br />Category <br />Number <br />- Taz Period Date of <br />Assmsmant <br />Amount of lax Penalty <br />Interest <br />Additiola Balance of <br />Assassmcm Due <br /> <br />O1 08-O1-82 thru <br />08-31-82 <br />11-22-82 <br />406:25 12.56 <br />8.26 <br />x27.07 <br /> <br />O1 09-01-82 thru <br />09-30-82 <br />11-22-82 <br />434.29 ~ 13.43 <br />3.55 <br />451.38 <br /> 1 ~ -- <br /> i <br /> <br /> I ~ <br /> <br /> TOTAL I S 878.45 <br /> i herebYcsrtify that the Nebraska Department of Revenue has tom pliee with the revenue laws of the State of Nebraska In the deter- <br /> mination oft mount -s wn to be due, antl the taxpayer has failed to pay the amount tlue after demantl. If this No[i<e Of State Tax <br /> L{en IS an lsiOn Of Ont~ue the prlOrltY of the Stete'S Interest in th <br />en <br />an e1 I ~e <br />5~~t0 e at}stied property of iha taxpayer. <br />Sigh ~ <br />/~ <br />~2^JT-G~ Revenue Agent 11-22-82 <br />~ p ax's}+~na'~ Ttt1e Date <br />~ / ,~- ` ~-_ _ <br />Special Agent <br />~ ~ 11-22-82 <br /> I'AUtho-~rizW 51 Lure - <br />Title Data <br /> ~ FOR COUNTY OFFICIAL'S USE <br />NE_ BRASKA DEPAR_ TMENT OF REV ENUE -White and Goldenrod Copies TAXPAYER -Pink Copy COUNTY OFFICE -Canary Copy <br />4494.74 Rev. 7-93 <br />Supersedes 4-490-74 Rev. 5-80 <br />lei <br />3 <br />