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nebraska <br />~hi Paramen ; <br />Piotice of State lax Lien <br />• Read instructions on reverse sills <br />Lren Senal Number County Date So<la1 Security Number <br />9j05/288 <br />Nebraska i.D. Number <br />~ ~} <br />2967.318 Hall <br />Lien Type <br />~ Original <br />~ Renewal 05/11/79 <br />Lien Filetl-W itn <br />J REgister of Dceds <br />C County Clerk 520-40-4249 <br />Spouse's Social Security <br />Number 79' t] <br />~ j <br />6USiNESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS ~~ <br />Bus+ness Name Name <br />POZ$er 7$'1tt..I~sr71S2S ray P02 fer <br />$Lf&gt Address Street or Other Mailing Adtlress <br />609 West :~ ~u~ 609 West Seventh <br />Gty State ZiP Code City State Zlp Coda <br />GraiY1 Island NE 68801 Grand Isl.ared _ NE 68801 <br />Pursuant to fhe revenue laws of the State of Nebraska, notice is hereby given that taxes {including penalties, interest <br />and additions) have been assessed and sre due from the above taxpayer and remain unpaid after demand. These taxes <br />const=,tute a lien upon property in the county belonging to the taxpayer or hereafter acquired. Liens for sales and use <br />vexes only attach to the real property of the Yaxpayer located within the county or hereafter acquired. <br />lax <br />Catayory <br />fdota~st <br />Tax Period Dste of <br />~e~pyM <br />Amount of Tax <br />Penalty <br />~ <br />Interest <br />Add itiom ~H^O0 °f <br />Aasesmant Due <br /> <br />01 to-ol-?? tttru <br />12-31-?7 <br />02-22-7 <br />9.53. <br />25.00 <br />.60 <br />35.43 <br /> <br />i <br /> <br />i i <br />{ <br /> ~ i i - I I <br />TOTAL ,S 35.43 <br />_ 1 neeepY <erttfr tndt the Nebraska Department of Revenue nas com pl+atl wrtn tnt revenue taws of tnt StalE of Nebraska in the defer <br />mandtlgn pt tfle a.rrount Stt°vYn SO be dUt, and in¢ tdxpdylr nay Taittl tD Pay lnE amount OuE after demand. 1f tnis Notic¢ O} $[dte Tax Lien it <br />- - an eYtlrtSiOFl Ol M etfait lYE 11tH it SErYGS t0 LOntinue the priOriiy Of tnE StdtE'z rn ttrCSt in tn! bf}lCttd PrOP¢rty Or [he YaYpdYEr. <br />s1~ t. (~~ ~_, ~~~~ gPeczal ant 05/11j79 <br />"" 7rtYe Datt <br />~~e <br />FOR COUNTY OFFICIAL'S USE <br />-NEBRASKA DEPARTMENT OF REVENUE -- Yitlr,te and Canary Cap+ez TAXPAYER - P<nk Copy CCYiiNTY OFFICE ~~ GotdErtr od Copy <br />I <br />f a.ava-za REy. s-~a <br />[~ sua¢rsrpes a-asana Rev. z-za <br />