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I,II. <br />nxDraska <br />d~bm„ent <br />'~ ~... plf nlylnu~e <br />NG~iC@ ~~' $t~'te'I'a~ ~.ie~t <br />• $airdi immkrueddne pn reverse ,ida ~'~ <br />(:,kn Sert~iai NfUmbkr ~ COUn ty Date ~5O C,u0.,l'~~.e~CUrit'y ~i.rmber I ~~ '/'fir-- ll £_ <br />@ <br />~I V ~f~t7 <br />9f10f674 Hall t 10-4-79 p <br />~ <br />NebrasW t.D. Number L~n Type <br />Orlgina; Lian Fiietl Wftn (Spouse's Social SOCUrIfy <br />Register of Deeds`Number <br />~t <br />1457322 ~ Renewal ~ County Clerk <br />BUSINESS NAME AND LOCATION ADDRESS J TAXPAYER NAME AND MAfInYG ADDRESS <br />Business Nama Nam! <br /> '4a h Pr d C r r ion <br />-Street tldress - Street ar Otner Malting Address <br />Hi v 3 2809 East Hi hwa 30 <br />City State Zip Code City Slate 2sp COM <br /> r nd 1 nd Ne 588 ] <br />Pursuant to the revenue laws of the State of Nebraska, notice u hereby given that taxes (including penalties, interest <br />and additions) have been assessed and are due from the above taxpayer and remain unpaid after demand. These taxes <br />constitute a Lien upon property belonging to the taxpayer, or hereafter acquired by the taxpayer, and located in the <br />above county.-Liens for sales and use taxes only attach to the real property belonging to the taxpayer, or hereafter <br />acquired by the taxpayer, and located in the above county. <br />Tax <br />Cit~Y <br />Number ` <br />~ Tax Period <br />- Dots of ~ <br />~ Assscsmerrc ~ Arnount of Tax ~ Penalty <br />~ r i <br />~ Interest ~ <br />~ Additions ~ 6eNnp of <br />Asst ihs <br /> <br />O1 rU ~ <br />' - - <br />j~31_79 ' <br />]0/3/79` 1,072.19 ~ 33.16 <br />~ 5.36 ' <br />~ i <br />- 1,110.71 <br /> <br />j ' <br />3 { i <br /> <br />r <br />~ i <br />~ t <br />j <br />-~ ~ . ~ ~_ <br />i i <br /> <br /> <br /> <br />TOTAL ,$ 1,110.71 <br />1 hereby certify that the Nebraska Depattment of Rlyanue has complied with the rovanue laws Of the State of Nebriska in the deta- <br />m[nation of the amount shown to be due, and the taxpayer has failed to pay the amount due after demand. If th{s Notice of State Tax Lbn Is <br />an extension of ah efisctiye Ilan ft Serves to Continue the ArloNty of the State's Interest In the affected property of the taxpayer. <br />~~ Spar•ial Agent ](!-4-79 <br />- ~,~$-.. ~AtftDOrlred Sip ure _ 'rate Dots <br />-- - - - - - _ - - FOR COUNTY OFFICIAL'S USE - - - - <br />NEBRASKA DEPARTMENT OF REVENUE -White and Canary Cpptes TAXPAYEA -Pink Copy COUNTY OFFICE - Gdldertrotl Copy <br />4494.74 Rw. 5.79 <br />Supersatles 4194.74 Rw. 9-78 <br />L_ <br />