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i <br />Native of Stete Tax Lien <br />r` ar~nebraska <br />~dOpartment - e Read instructions an reverse side <br />Lien Serial Number County Date Social Security Number <br />9/03/131 iEsll 3-2-79 505-56-5228 7~"°' ~ ~ ~ ~3 <br />Nebraska 1. D. Number lien Type Lien Filetl With Spouse's SOCia! Security <br /> (S'i Original ~ Register o4 Oeetls Number <br /> <br />__ Renewa4 ~ County Clerk 506-60-596 <br />... . .:........ .. ~~ 1 <br />~- HUSINESD NAMt ANV IVtiiil fain HVUncu '-"""----- <br />Business Name Nante Thomas L. Piiller & Barbara G. Miller <br />Ba Loun a Jointl and Seves'ally <br />Street Atltlress Street or Other Ma4nng Adtlress <br />3311 Sdest Stoney Park Road 107 Come*_ Court <br />Stat¢ ZID Cotle City State 2iP Code <br />City 68870 <br />Grand-~s1.aAd_ NE 68801 Alda NE <br />Pursuant io the revenue laws of the State of Nebraska, notice is hereby given that taxes (including penalties, htterest <br />and additions) have been assessed and are due from the 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. Liens for sales and use <br />taxes only attach to the real property of rite taxpayer located within the county or hereafter acquired. <br />Tax <br />Ca28gwY <br />Humber <br />Tax Period Oate of <br />Ass~snserrt <br />Amount of Tax <br />Penalty <br />interest <br />Additions Balance of <br />Assessmanf Oue <br /> <br />O1 12 Ol 78 thru <br />12/31/78 <br />3/5/79 <br />575.10 <br />17.74 <br />5.76 <br />598.65 <br />! OI/01/79 thru <br />0 <br />3 5 79 ~ <br />42.43 <br />5.00 { <br />.21 <br />47.64 <br />~ f <br /> <br />-~ - <br /> <br /> <br />RepOrtina under Nebraska Identification ~JO Q1-2221594 TOTAL i$ 646.29 <br />1 n¢t¢by certify that the Nebraska D¢partm ent of Revenue nas com Rlied with the revenue laws of the State of Nebraska in Fhe tleteh <br />minalian of the 2mount shown to be tlue, antl tn2 taxpayer hat failed to Pay the amount tlue after tlemantl. If this Notice of State Tdx Lien is <br />an ax.en5ian of an effective lien it 5¢rve5 to Continue Lhe priority at the ."state'' int¢resi in fire affected property of the taxpayer. <br />~~~~ ~-~ ~ Special Agent 3/6/79 <br />~EtB Autnorizetl ~9na a Title Date <br />FOR COUNTY OFFICIAL'S USE _. _ <br />NEBRASKA DEPARTMENT OF REVENUE -White and Canary Copies TAXPAYER -Pink Cagy GOUNTY OFFICE -Goldenrod Copy <br />4-494.74 Rev. 478 <br />Supersedes A-494.71 Rev. 2-78 <br />... -.... <br /> <br />