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nxbraska <br />-~ eartemeni <br />i <br />e Read instructions on rwvenrt slda <br />Lien Serial Number County Date Soclal Security Nuntbar <br /> <br /> <br />Nebraska I <br />Number <br />D <br /> <br />Lien T <br />e <br /> <br />Li <br />n Fil <br />d Wifh <br />6- - <br />S <br />' <br />2 <br />l t <br />7~~-'~~3~1~:3~~ <br />. <br />. yp <br />® Original e <br />x <br />~' Re s;~t.r of Deed3 pouse <br />s Socia <br />Number Security <br /> Renewal C County Clerk <br />-BUSINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ApDRESS <br />Bus/nass Name Name <br />.Bobs Kustom Biit Hones Robert Laskowski <br />Stroet Address Street or Other Mailing Atl dress <br />922 West Louise Box 733 922 West Louise Box 733 <br />Crty - State Zip Code City State Zip Codx <br />Grand Island :1L 68801 Grand Island NE 68801 <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 runty betongiutg to [he taxpayer or hereafter acquired. Liens for sales and use <br />taxes only attach io the real property nF the taxpayer located within the county or hereafter acquired. <br />Tax <br />- - <br />Ndmbev <br /> <br />Yax varibd Dats df <br /> <br />Assssrnetzt <br /> <br />Amount oT Tax <br /> <br />Penalty <br />~ <br />Interest <br /> <br />Addi{iotet <br />rsf <br />~tttartt Ow <br /> <br />2~_ 1/i/78 thru <br />1 78 <br />3 16 7 <br />11.82 <br />.59 <br />.65 <br />13.06 <br /> <br />~- 411/78 thrtt <br />28 2 <br /> 711178 thru <br />78 <br />16 79 <br />72.00 <br />3:60 <br />1.80 <br />77,40 <br /> 10/i/78 tbru <br />1 7 <br />8 88 <br />2.94 <br />.59 <br />62.41 <br /> <br /> <br /> I <br />rOTAI ~S 181 39 <br />1 Hereby Certify that Sne Nebrsskd Depir{mtlfi of Rerenu! has Complied wi:h the rwenue laws pf tttt State of Nebraska in tn! deter- <br />minatzon of the amoum Shown [o be due, dnd *-ne taxpayer has taL1eC to pay the amount tlue niter demand. if this Nonce of Stale Tax Lien ~s <br />an extertslfln flf dA atfecitve :Len i2 servef t0 LOnt:nux th! prlOf;ty Of th! $taTe's lntelesL {n the d}}eCiatl prOpxrfy O} Ind taxpaym. <br />FOR <br />NEBRASKA DEPARTMENT OF REVENUE - yWtrte and Canary Copies <br />Special aaeat 3/16/79 <br />T7tte Date <br />OFFiC7At.3 USE <br />7AXPAYER - Pmk Copy <br />C{}UNTY OFFICE - Goldenrod Copy <br />a-39474 Rev. 9-78 <br />Supersedes 4.49479 Rev. 2-7e <br />J <br />