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~~rsebraska ~Zpa::^`€nt • head instructions on reverse side lien Serial Number County Date Social Security Number ~~~ i~~ l ~~~ 9j03j154 Hall 3j12/? . - Nebraska I.D. Number- Llen Type Lien. Filetl yl ith Spouse's Social Security } Original ~tegister of Deetli Number 01-1457322 l ~ Renewal ~ County Clerk BUSINESS NAME AND LOCATION AODPtESS 1 AhYArCts ntAltlst ANV MAlitrvts AUURCJ.I Eus~ness Name Name Mayhew Products Corporation Mayhew Products Corporation StrePf Address - I Street or Other Mailing Address 2809 East Highway 34 1 2849 East Highway 30 City State Zip Cotle City State Zip Code Grand Island. I3E 68841 I Grand Island NE 6$841 Pursuant to the revenue laws of the State of Nebraska, notice is hereby given that taxes (including penalties, interest and additions) have been assessed and are due from the above taxpayer and remain unpaid after demand. These taxes constitute a lien upon property in the county belonging to the taxpayer or hereafter acquired. Liens for sales and use taxes only attach to the real property of the taxpayer located within the county or hereafter acquired. ~ Tax ~i Cate9nry Number Tax Period Date of ~~~ Amovnt of Taz Penalty ~ I interest Additions balance of Assessment Due ljl/75 thru -, - ~ i - ToTal_ Is 828.37 ' I Hereby Certify ina4 The Nebraska Department of Revenue nos Comahad wrtri the rovanue laws o1 the State of Nebraska in the tleter- urination of the amount mown to be due, antl the taxpayer nos faired to pay the amount due after demand. It tors Notice of State Tax Lien is an extension of an effective lien it 5arye5 to cpntinue the priority of the State's interest in the affected property of the taxpayer- S~gR Q epecial Agent 3/14/79 _ ~ ,~~~~ Auto oriled Signet Title Data FOR COVNTY OFFICfAL'S USE NEBRASKA DEPARTMENT OF REVENUE -White and Canary Copies TAXPAYER -Pink Copy COUNTY OFFICE -Goldenrod Cppy - - 4-494-74 Rev 9.78 ([ Supersedes 4.494-74 Rev. 2-78 l - - G