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<br />Notice of Mate Ta~c Lien <br />RNJraSRa <br />t)et)artltlNnt • Read InSifUCttonS Oft MY@!,@ sid0 ~^ _ _- <br />4)t ft ntl?! _ _ <br />~,an Sar:ai f•9urnber County i Date (( o[iai Sew rity ~:u rnbet <br />9L02f116 ~Iia 1 2 ZS 79 <br />Nebras~ l.D. Number Lfen Type Liert Filetl 'Kith Sppuse's Social Security <br />Oriyinal t~[Ragi§ter-pt Oeesas Numbe' <br />t *3'f RI.LC : I i f ~<rtev:21 ir!. C0.!.nty ('iwrk _ <br />~ aUStirEaS NAME AND LOCR7lt5td ADDRESS 1 TAXPAYER NAME AND MAILSNG ADDRESS <br />business Name - Na m< <br />~~.~~ist.Pat6r.2EA f;4 TaC. ~Se eiu°i ,• ,•.•a C~. n~P f",~; TIIS. <br />Dth Maflg AGtlr<Ss <br />t <br />Street Atltlress stree <br />or <br />P~ 0. &ox 1665 P. 0. Sox 1665 <br />city State Zip Cod< city State - Zia Cotl¢ <br />Grand Island NE 68801 Grand islattd NE 68801 <br />Pursuant to the revenue taws of the State of Nebraska, notice is hereby given that taxes (including penalties, interest <br />and additions) have been assessed and are due from #ire above taxpayer and remain unpaid after demand. These taxes <br />constitute a lien upon property in the county belonging to the taxpayer or hereafter acquired. Lietts for sales and use <br />taxes only attach to the real property of the taxpayer locatrd within the county or hereafter acquired- <br />lax <br />I Category <br />~_ Number <br /> <br />21 ; 1 i <br />Tax Period <br /> <br />0 Ol thru <br />06(30/77 pMe of ~ <br />ASassmam <br /> <br /> <br />1/31/781 <br />Amount of Tax <br /> <br /> <br />241.40 II <br />~; Interest <br />~ <br /> <br />45.55 ~ 24,14 - <br />Atiditiotte Bafattte bt <br />Asseastnant Due <br />_ <br /> <br />361.09 <br />_ <br />21 07 O1 77 thru <br />09/30(77 <br />1]31(78 <br />1,011.66 <br />~_ 50.58 85.99____+ <br />,_^ <br />i 148,23 <br /> <br />21 1Of01/77 tttru , <br />12131177 ! <br />9/27/78 <br />380.33 <br />19.02 26.56 <br />_ <br />425.95 <br />- -- I-- }T ~ <br />I ~- ' -( <br />I -- <br />~' t ~ I ~ 1 <br /> I + - <br />T07AL ~$ 1,935,17 -- <br />i n¢Yeoy Certify that the Nebraska DePartrn Ent at Rev nUe has comptietl w?[h the revenue haws O1 tna State of Nebraska in the tleter~ <br />m irtation of the amDUni snows to he tlue, antl tn¢ taxpayer has to uetl to pa4 the amnunt oue after tlemantl. if this Notice of Slate Tax Lien Fs <br />#~ an extension of an e`iective !ten t: Serves tc coniinU¢ the priority ai t^.¢ $tate•§ fnI<resf In ihE dfiECiEtl property Of ih< taxpdYar. <br />S9g1i ~ Special 9geat 3/2f79 <br />~, hire Autito'i2ef3 Sig tore Tiri¢ Date <br />~. .. FDR COUNTY C'FF{C1AL'S tJSE <br />