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Notice of S#ate Tax Lien ~~nebraska department • Read instrut:tiorta on revane side f. -_--_~ Lien Serial Number County Date Soria! Security Number 79'~ 9/04/246 Hall 04/25/79 508-54-4679 U ~! 2 S Nebrasfea I.D. Number en Type Lien Filetl With SppuSe'z SpElai Security Original '~ Register of (leads Number O1-2966409 Q Renewal u County Clerk SUStNESS NAME AND IOCATiON ADDRESS TAXPAYER NAME AND MAit-ING ADDRESS Bu5ine55 Name Name Haroids Repair _ Harold %awrence street ACEress Street or Dthar Mailing AECre55 Community Service Platte Valle Trailer Court Lot 8 City State Zip Code City State - Ztp Cobe Central Citq NE b882b Central Citv NE 68826 Pursuant to the revenue Taws of the State of Nebraska, notice is hereby given that taxes (including penalties, interes! and additions) have been ~+sessed and are due from the above taxpayer and remain unpaid after demand. These taxes constitute a lien open 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 acyuired. Tax Geteaory Number Tax Period pan of A~rtteM Amount of Tax Penalty IMeren Addiit,:sis 8elanu of p~e6e~t Dw O1 09 O1 7 thru 09/30/78 02/06/79 4.83 5.00 .12 9.95 O1 10 O1 7 thru 10/31/78 02/06/79 15.92 5.00 .40 21.32 _ Oi 11/01/78 thru 11/30/78 02/06/79 11.73 5.00 .24 16.97 TOTAL ($ -4$.24 1 hereby certify that the Nebraska Department of Revenue nas complietl with the revenue laws of the State of Nebraska in the Oater urination ofi the amount shown to be cue, anG the taxpayer has failetl to pay the amount tlue after tlemand. If this Notice of State Tax Lian is an extension of an effective lien It Yervez to continue the pYiorily of the SYate'S interest In the of fected property of Lhe taxpayer. S1~1f Special Agent 04/25/79 ~ei a Authorizotl Si Lure Title Date _ fOR COUNTY OFFICIAL'S USE -