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Notice of Mate 'fex Lien <br />nebraska <br />napartment- _ _ _ • Read instructions on reverse aide <br />t ra <br />Lien Serial Number county Date - Sottal Security Number <br />9/03j164 Hall 3/16/79 505-56-5228 79-.~~~z1~~~ <br />Nebraska t.D. Number Lien Type Lien Filetl With Spouse's Sot{al `ieturitY <br /> ~Or{9inai ~ .°.:gi:ter of Deetl; Number <br />- ~ Renewal Q County C1alY <br />BUSINESS NAME AND LOCATION ADDRESS ! TAXPAYER NAME AND MAILING ADDRESS _ __ <br />Business Name Name Thomas L, and Barbara G. Miller <br />.3311 West Stolle Park Road 107 Comet Court <br />Cixy ~ State .Zip Cotle City State Zia Code <br />Grand Island NS 68801 Alda NE 68870 <br />Parsuant 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 acquired. Liens for sales and use <br />taxes only attach to the real property Wit' the taxpayer located within the county or hereafter acquired. <br />Tax <br /> <br />~tehrnY <br />Number <br /> <br />Tax Petted <br />Date of 1 <br />Asse~rrtsm <br /> <br />Atrtount of Tax <br /> <br />Penalty - <br /> <br />Interest <br /> <br />Adtlitiosts <br />Bstance of ----- - <br />Ast:eY+nKtt Dta <br /> la/ul/7s tt~ <br /> <br /> <br /> <br /> <br /> <br /> <br />TOTAL ~5 134,a~ <br />1 htreby tUtify that the IVebriaka vc.ryrfinent of Revenu! h85 Cptnpiierl Witn tn! teYenUe IaWa pf the State of Nepraskd in th@ detef- <br />miaatiort at Ina anecunf stwwn to be due. arut xne taxpayer nas failed to pay the amount a+x after demantl. it thin Notite at State Tax Lien t4 <br />M extension or an ettective 3fan it xrves to Continue the priority of the State's interest in the affected R*aperty of the taxpayer. <br />Special Ott 03/21J79 <br />AalAOrtaed Tftle Date <br />_ FOR COUNTY OFRCIAL'S ttSE <br />- - NESRASY.A UEPARTS#ENT OF R£V£NU£ - 1RRtita and Canary Copses TAXPAYER - Plnk Copy COUNTY OFFiC£ -Goldenrod Copy <br />' 4-49474 Rev_ 9-7a <br />- - Supersedes 449444 Rev- 2.78 <br /> <br />