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ebraska <br />department <br />IVo#ice of state Tax Lien <br />• Read instructions on reverts side <br />Lien Serial Number County Date Social Security Number <br />9j43/133 Hall ~ 3/2/79 505~44~3012 7g-.. ~~ ~~ !~ ~ ~ 2 <br />N¢braska 1.D. Mumb¢r n Type <br />L <br />ie Lien Filetl With Spouse's SOGial Set unity <br />2l°2734559 ~ <br />'~ <br />~Origlnal [~ Register of Deetls Number <br />' Renewal C County Clerk ~ <br />i BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND ARAILING ADDRESS _~ <br />Business Name J B v ~~ AS~7.d~r Ilit:. Name <br />sireet';3: dr¢ss <br />l3c>x 1665 _ sir¢et <br />City State Zip Cotle City State Zip Coae <br />;rand Tsland, ILIE 68801 ___ Takc arrri m Rm1S <br />Pursuant to the revenue laws of the State of Nebraska, notice is hereby given that taxes {including penalties, interest <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 acquued. Liens for sales and use <br />taxes only attach to the real property of the taxpayer located within the county or hereafter acquired. <br />Tax Date of j ~ ~~n~ of I <br />~CategmV ~ <br />Nutrdaer Tax Period Aa~ment Amount of lax Penalty Interert Additions Assessment Due <br />~ 04j01/77 ~ru <br />2l 06 30 77 4 24 8 888.42 197.54 ~ 105.48 1 1 1 4 <br /> <br />-__~1 07/O1j77 ttu'u <br />~ 07135/7 <br />~48 G,9~ <br />- ~53.5~ <br />- - <br /> <br />i i -- <br />I <br />i <br />r ~ <br /> <br />I I , <br /> <br />i <br />I t <br /> <br />i i <br />~ <br />z <br />TOTAL I~ 1,845.02 <br />I Hereby <ertl/y that the Nebraska Department of Revenue nas Complied wl[h the revenue laws of the State of Nebraska ir. the tleter- <br />raFiofl of Eh¢ am punt shown to tre due. and the taxpayer ttas 42i!ed to pay the amount tlue aft¢r tlemantl. If this NptiCe of State Tax lien is <br />an' ext¢n5ipn pf an E!f¢CS eve lien it Selv¢5 !p toni!rtue the pri Ority pt the State s inter¢SI ~n the dffe Cietl property pf th2 taz payer. <br />s~g~s ~ <br />~1e t'~ ~-- ~~- ~t 317/79 <br />Autnorlletl 5~9natr Title Date <br />FOR COUNTY OFFtC1At'S USE <br />NEBRASKA OEPARTh1ENT OF REVENUE - Wlhne and Canary Copies TAXPAYER -Pink Copy <br /> <br />COVNTY OFFICE -Goldenrod Copy <br />4-494-74 Rev. 9-78 <br />Supersetles 4-494-74 Rev. 2-TB <br /> <br />i~ <br />