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<br /> INSTRUCTIONS <br />PURPOSE OF FORM. This farm is to be used by the Nebraska <br />Department of Revenue for the purpose of notifying the appropriate <br />- ''ebutity.~uthorities That a Nebraska Notice of State Tax Lien is being <br />filed against the taxpayer indicated on this form. <br />The tax category number codes and the Nebraska tax oragrams they <br />represent are lis ted below. <br />01 .: .. ...:.....................Sales Tax <br />02 .... ....................Retailers Use Tax <br />04 .... ...... . ..:........Consumers Use Tax <br />1 i .... ........................ Part-mutuel <br />18 .... ........................ Estate Tax <br />2i .... ....:..........Income Tax Withhold[ng <br />22 .... ................Individual Income Tax <br />23 .... .................Fiduciary Income Tax <br />24 .... ......................Corporate Tax <br />35 .... .......................:.Bingo Tax <br />52 .... ...............Documentary Stamp Tax <br />57 .... .......................Cigarette Tax <br />61 . . .. ................. . ....Severance Tax <br />71 .... .........interstate Motor Carriers Fuel Tax <br />8I .... .......Motor Vehicle Fuels Imparting Dealer <br />85 .... ......................Aircraft Fuets <br />. 9I .... .......................Special Furls <br />;~ ~ <br />~t ~ l <br />~, c~ 1 ~_ ~ ~ Ott ~_~~ ~~ ~1 <br />I i. a ~ ~ ~` <br />Lei `~ C, t}7 O Sri <br />~~ ~ ~ ~ ~ ~~ riw <br />.~ <br />~. <br />~.~ <br />~ __ <br /> <br />